Key result
In a middle-aged general population, the prevalence of diastolic dysfunction was 12.7%, with asymptomatic dysfunction associated with hypertension and HbA1c, and HFpEF strongly associated with CAD, COPD, and atrial fibrillation.
Why the study?
Left ventricular diastolic dysfunction is common in the general population and associated with HFpEF, but its prevalence and correlates in subjects with and without HFpEF needed evaluation in a middle-aged general population sample.
Cross-Sectional (n=5,913)
No
In a general middle-aged population, asymptomatic diastolic dysfunction is common and primarily associated with hypertension and age, whereas symptomatic HFpEF is strongly linked to additional comorbidities like CAD, COPD, and atrial fibrillation.
AIM: Left ventricular diastolic dysfunction (DD), a common finding in the general population, is considered to be associated with heart failure with preserved ejection faction (HFpEF). Here we evaluate the prevalence and correlates of DD in subjects with and without HFpEF in a middle-aged sample of the general population. METHODS AND RESULTS: From the first 10,000 participants of the population-based Hamburg City Health Study (HCHS), 5913 subjects (mean age 64.4 ± 8.3 years, 51.3% females), qualified for the current analysis. Diastolic dysfunction (DD) was identified in 753 (12.7%) participants. Of those, 11.2% showed DD without HFpEF (ALVDD) while 1.3% suffered from DD with HFpEF (DDwHFpEF). In multivariable regression analysis adjusted for major cardiovascular risk factors, ALVDD was associated with arterial hypertension (OR 2.0, p < 0.001) and HbA1c (OR 1.2, p = 0.007). Associations of both ALVDD and DDwHFpEF were: age (OR 1.7, p < 0.001; OR 2.7, p < 0.001), BMI (OR 1.2, p < 0.001; OR 1.6, p = 0.001), and left ventricular mass index (LVMI). In contrast, female sex (OR 2.5, p = 0.006), atrial fibrillation (OR 2.6, p = 0.024), CAD (OR 7.2, p < 0.001) COPD (OR 3.9, p < 0.001), and QRS duration (OR 1.4, p = 0.005) were strongly associated with DDwHFpEF but not with ALVDD. CONCLUSION: The prevalence of DD in a sample from the first 10,000 participants of the population-based HCHS was 12.7% of whom 1.3% suffered from HFpEF. DD with and without HFpEF showed significant associations with different major cardiovascular risk factors and comorbidities warranting further research for their possible role in the formation of both ALVDD and DDwHFpEF.
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Wenzel et al. (2021) conducted a cross-sectional in Diastolic dysfunction and Heart failure with preserved ejection fraction (HFpEF) (n=5,913). Cardiovascular risk factors and comorbidities vs. Normal diastolic function was evaluated on Prevalence of diastolic dysfunction. In a middle-aged general population, the prevalence of diastolic dysfunction was 12.7%, with asymptomatic dysfunction associated with hypertension and HbA1c, and HFpEF strongly associated with CAD, COPD, and atrial fibrillation.
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