Samdarshi Tandaw E, Taylor Herman A, Edwards Derrick Q, Liebson Philip R, Sarpong Daniel F, Shreenivas Satya S, Howard George, Garrison Robert J, Fox Ervin R
The University of Mississippi School of Medicine, Jackson, MS 39216, USA.
Am Heart J. 2009 Aug;158(2):209-16. doi: 10.1016/j.ahj.2009.05.020.
The objective of this study is to investigate the distribution and determinants of diastolic function in a middle-aged cohort of African Americans (AA).
The distribution and determinants of left ventricular (LV) diastolic function in AA are not well-described despite high rates of AA with diastolic heart failure and a five-fold higher risk of death in those with diastolic dysfunction (DD) compared to normal diastolic function.
Four categories of diastolic function were defined in JHS participants undergoing echocardiograms at the first examination (2001-2004) using mitral and pulmonary vein velocities. Investigators used logistic regression to assess the independent relation of DD to traditional risk factors and LV systolic dysfunction.
Of the 3,571 study participants (mean age, 56 +/- 12 years; 63.9% female), 70.4% had normal diastolic function, and 18.0%, 10.6%, and 0.9% had mild, moderate, and severe DD, respectively. In the multivariable analysis, DD was significantly related to age (OR 1.2, 95% CI 1.1-1.4), male sex (OR 1.3 CI 1.0-1.5), LV systolic dysfunction (OR 1.5, CI 1.2-2.0), body mass index (OR 0.8, CI 0.8-0.9), and heart rate (OR 1.2; CI 1.1-1.2). The severity of DD was significantly related with age (OR 0.3; CI 0.3, 0.4), male sex (OR 1.6; CI 1.2-2.2), hypertension (OR 0.6, CI 0.4-0.8), and heart rate (OR 0.7; CI 0.6-0.8).
This is the largest community-based analysis of LV diastolic function in middle-aged AA. DD was present in 29.5% and independently related to several traditional risk factors and LV systolic dysfunction.
本研究的目的是调查非裔美国人（AA）中年队列中舒张功能的分布及其决定因素。
尽管AA人群中舒张性心力衰竭的发生率较高，且舒张功能障碍（DD）者的死亡风险比舒张功能正常者高五倍，但AA人群左心室（LV）舒张功能的分布及其决定因素尚未得到充分描述。
在首次检查（2001 - 2004年）时对接受超声心动图检查的杰克逊心脏研究（JHS）参与者，使用二尖瓣和肺静脉流速定义了四类舒张功能。研究人员采用逻辑回归评估DD与传统危险因素及LV收缩功能障碍之间的独立关系。
在3571名研究参与者中（平均年龄56±12岁；63.9%为女性），70.4%舒张功能正常，18.0%、10.6%和0.9%分别有轻度、中度和重度DD。在多变量分析中，DD与年龄（比值比[OR]1.2，95%置信区间[CI]1.1 - 1.4）、男性（OR 1.3，CI 1.0 - 1.5）、LV收缩功能障碍（OR 1.5，CI 1.2 - 2.0）、体重指数（OR 0.8，CI 0.8 - 0.9）和心率（OR 1.2；CI 1.1 - 1.2）显著相关。DD的严重程度与年龄（OR 0.3；CI 0.3，0.4）、男性（OR 1.6；CI 1.2 - 2.2）、高血压（OR 0.6，CI 0.4 - 0.8）和心率（OR 0.7；CI 0.6 - 0.8）显著相关。
这是对中年AA人群LV舒张功能进行的最大规模的基于社区的分析。DD的发生率为29.5%，且与多种传统危险因素及LV收缩功能障碍独立相关。
