Comparing the influence of 2009 versus 2016 ASE/EACVI diastolic function guidelines on the prevalence and echocardiographic characteristics of preclinical diastolic dysfunction (stage B heart failure)in a Hispanic population with type 2 diabetes mellitus

Siu Hin Wan, Andrew S. Pumerantz, Fanglong Dong, Cesar Ochoa, Horng Haur Chen

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Abstract

Aims: To identify prevalence and predictors of undetected pre-clinical diastolic dysfunction (PDD)in a cohort of adult Hispanic patients with type 2 diabetes (T2D), and compare variations in epidemiology and echocardiographic characteristics between categorization based on the 2009 versus 2016 guidelines. Methods: From 2013 to 2016, a cross-sectional cohort study of adults with T2D was performed. Patients without signs/symptoms of heart failure (HF)underwent 2D/Doppler echocardiographic screening, and were grouped into two subcohorts: 1)normal diastolic function, and 2)PDD, defined by the 2009 or 2016 ASE/EACVI criteria. Results: Among 307 Hispanic subjects, by 2009 criteria, 193 (62.9%)had normal diastolic function, 113 (36.8%)diastolic dysfunction and 1 (0.3%)indeterminate. Those that had diastolic dysfunction (DD)were older (mean age 59.1 ± 12.7 vs 52.2 ± 12.2 years, p < 0.0001), with higher proportion female (69.0 vs 53.9%, p = 0.0092), and higher systolic blood pressure (136.5 ± 18.6 vs 131.7 ± 19.9, p = 0.0372). By 2016 criteria, 261 (85%)had normal diastolic function, 22 (7.2%)diastolic dysfunction and 24 (7.8%)indeterminate. Among those that had normal diastolic function (n = 261)by 2016 criteria, 29% (n = 76)had DD by 2009 criteria, and they were more likely to have higher E/e′ and left atrial volume index (LAVI). Conclusions: By applying the 2016 versus the 2009 diastolic function criteria to a Hispanic population with T2D, the prevalence of PDD decreased significantly from 37% to 7%. These findings are consistent with recent studies demonstrating that the 2016 ASE/EACVI guidelines are more specific for diagnosing DD and hence less sensitive leading to lower prevalence of diastolic dysfunction.

Original languageEnglish (US)
JournalJournal of Diabetes and its Complications
DOIs
StatePublished - Jan 1 2019

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Hispanic Americans
Type 2 Diabetes Mellitus
Heart Failure
Guidelines
Population
Signs and Symptoms
Epidemiology
Cohort Studies
Cross-Sectional Studies
Blood Pressure
Hypertension

Keywords

  • Echocardiography
  • Epidemiology
  • Heart failure
  • Hispanic
  • Pre-clinical diastolic dysfunction
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

@article{14c89291bde44920bf35d3863c8bd9b6,
title = "Comparing the influence of 2009 versus 2016 ASE/EACVI diastolic function guidelines on the prevalence and echocardiographic characteristics of preclinical diastolic dysfunction (stage B heart failure)in a Hispanic population with type 2 diabetes mellitus",
abstract = "Aims: To identify prevalence and predictors of undetected pre-clinical diastolic dysfunction (PDD)in a cohort of adult Hispanic patients with type 2 diabetes (T2D), and compare variations in epidemiology and echocardiographic characteristics between categorization based on the 2009 versus 2016 guidelines. Methods: From 2013 to 2016, a cross-sectional cohort study of adults with T2D was performed. Patients without signs/symptoms of heart failure (HF)underwent 2D/Doppler echocardiographic screening, and were grouped into two subcohorts: 1)normal diastolic function, and 2)PDD, defined by the 2009 or 2016 ASE/EACVI criteria. Results: Among 307 Hispanic subjects, by 2009 criteria, 193 (62.9{\%})had normal diastolic function, 113 (36.8{\%})diastolic dysfunction and 1 (0.3{\%})indeterminate. Those that had diastolic dysfunction (DD)were older (mean age 59.1 ± 12.7 vs 52.2 ± 12.2 years, p < 0.0001), with higher proportion female (69.0 vs 53.9{\%}, p = 0.0092), and higher systolic blood pressure (136.5 ± 18.6 vs 131.7 ± 19.9, p = 0.0372). By 2016 criteria, 261 (85{\%})had normal diastolic function, 22 (7.2{\%})diastolic dysfunction and 24 (7.8{\%})indeterminate. Among those that had normal diastolic function (n = 261)by 2016 criteria, 29{\%} (n = 76)had DD by 2009 criteria, and they were more likely to have higher E/e′ and left atrial volume index (LAVI). Conclusions: By applying the 2016 versus the 2009 diastolic function criteria to a Hispanic population with T2D, the prevalence of PDD decreased significantly from 37{\%} to 7{\%}. These findings are consistent with recent studies demonstrating that the 2016 ASE/EACVI guidelines are more specific for diagnosing DD and hence less sensitive leading to lower prevalence of diastolic dysfunction.",
keywords = "Echocardiography, Epidemiology, Heart failure, Hispanic, Pre-clinical diastolic dysfunction, Type 2 diabetes",
author = "Wan, {Siu Hin} and Pumerantz, {Andrew S.} and Fanglong Dong and Cesar Ochoa and Chen, {Horng Haur}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jdiacomp.2019.04.015",
language = "English (US)",
journal = "Journal of Diabetes and its Complications",
issn = "1056-8727",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Comparing the influence of 2009 versus 2016 ASE/EACVI diastolic function guidelines on the prevalence and echocardiographic characteristics of preclinical diastolic dysfunction (stage B heart failure)in a Hispanic population with type 2 diabetes mellitus

AU - Wan, Siu Hin

AU - Pumerantz, Andrew S.

AU - Dong, Fanglong

AU - Ochoa, Cesar

AU - Chen, Horng Haur

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Aims: To identify prevalence and predictors of undetected pre-clinical diastolic dysfunction (PDD)in a cohort of adult Hispanic patients with type 2 diabetes (T2D), and compare variations in epidemiology and echocardiographic characteristics between categorization based on the 2009 versus 2016 guidelines. Methods: From 2013 to 2016, a cross-sectional cohort study of adults with T2D was performed. Patients without signs/symptoms of heart failure (HF)underwent 2D/Doppler echocardiographic screening, and were grouped into two subcohorts: 1)normal diastolic function, and 2)PDD, defined by the 2009 or 2016 ASE/EACVI criteria. Results: Among 307 Hispanic subjects, by 2009 criteria, 193 (62.9%)had normal diastolic function, 113 (36.8%)diastolic dysfunction and 1 (0.3%)indeterminate. Those that had diastolic dysfunction (DD)were older (mean age 59.1 ± 12.7 vs 52.2 ± 12.2 years, p < 0.0001), with higher proportion female (69.0 vs 53.9%, p = 0.0092), and higher systolic blood pressure (136.5 ± 18.6 vs 131.7 ± 19.9, p = 0.0372). By 2016 criteria, 261 (85%)had normal diastolic function, 22 (7.2%)diastolic dysfunction and 24 (7.8%)indeterminate. Among those that had normal diastolic function (n = 261)by 2016 criteria, 29% (n = 76)had DD by 2009 criteria, and they were more likely to have higher E/e′ and left atrial volume index (LAVI). Conclusions: By applying the 2016 versus the 2009 diastolic function criteria to a Hispanic population with T2D, the prevalence of PDD decreased significantly from 37% to 7%. These findings are consistent with recent studies demonstrating that the 2016 ASE/EACVI guidelines are more specific for diagnosing DD and hence less sensitive leading to lower prevalence of diastolic dysfunction.

AB - Aims: To identify prevalence and predictors of undetected pre-clinical diastolic dysfunction (PDD)in a cohort of adult Hispanic patients with type 2 diabetes (T2D), and compare variations in epidemiology and echocardiographic characteristics between categorization based on the 2009 versus 2016 guidelines. Methods: From 2013 to 2016, a cross-sectional cohort study of adults with T2D was performed. Patients without signs/symptoms of heart failure (HF)underwent 2D/Doppler echocardiographic screening, and were grouped into two subcohorts: 1)normal diastolic function, and 2)PDD, defined by the 2009 or 2016 ASE/EACVI criteria. Results: Among 307 Hispanic subjects, by 2009 criteria, 193 (62.9%)had normal diastolic function, 113 (36.8%)diastolic dysfunction and 1 (0.3%)indeterminate. Those that had diastolic dysfunction (DD)were older (mean age 59.1 ± 12.7 vs 52.2 ± 12.2 years, p < 0.0001), with higher proportion female (69.0 vs 53.9%, p = 0.0092), and higher systolic blood pressure (136.5 ± 18.6 vs 131.7 ± 19.9, p = 0.0372). By 2016 criteria, 261 (85%)had normal diastolic function, 22 (7.2%)diastolic dysfunction and 24 (7.8%)indeterminate. Among those that had normal diastolic function (n = 261)by 2016 criteria, 29% (n = 76)had DD by 2009 criteria, and they were more likely to have higher E/e′ and left atrial volume index (LAVI). Conclusions: By applying the 2016 versus the 2009 diastolic function criteria to a Hispanic population with T2D, the prevalence of PDD decreased significantly from 37% to 7%. These findings are consistent with recent studies demonstrating that the 2016 ASE/EACVI guidelines are more specific for diagnosing DD and hence less sensitive leading to lower prevalence of diastolic dysfunction.

KW - Echocardiography

KW - Epidemiology

KW - Heart failure

KW - Hispanic

KW - Pre-clinical diastolic dysfunction

KW - Type 2 diabetes

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DO - 10.1016/j.jdiacomp.2019.04.015

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SN - 1056-8727

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