Difference in the prevalence of subclinical left ventricular impairment among left ventricular geometric pattern in a community-based population

• Published in: Journal of cardiology 2020-04, Vol.75 (4), p.439-446
• Main Authors: Hasegawa, Takuya, Asakura, Masanori, Asanuma, Hiroshi, Amaki, Makoto, Takahama, Hiroyuki, Sugano, Yasuo, Kanzaki, Hideaki, Yasuda, Satoshi, Anzai, Toshihisa, Izumi, Chisato, Kitakaze, Masafumi
• Format: Article
• Language: English
• Subjects: Aged; Community-based population; Diastole; Diastolic dysfunction; Echocardiography; Female; Heart Ventricles - diagnostic imaging; Heart Ventricles - pathology; Heart Ventricles - physiopathology; Humans; Hypertrophy, Left Ventricular - diagnostic imaging; Hypertrophy, Left Ventricular - epidemiology; Hypertrophy, Left Ventricular - pathology; Hypertrophy, Left Ventricular - physiopathology; Left ventricular hypertrophy; Male; Middle Aged; Prevalence; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - epidemiology; Ventricular Dysfunction, Left - pathology; Ventricular Function, Left
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2019.09.007

•Left ventricular (LV) diastolic dysfunction was more frequently observed in subjects with LV hypertrophy.•LV mass, not relative wall thickness, was a determinant of LV diastolic dysfunction.•Ten percent of subjects with normal LV geometry had LV diastolic dysfunction.•Clinical impact of subclinical LV diastolic dysfunction should be elucidated. Left ventricular (LV) hypertrophy is reported to cause LV diastolic dysfunction. This study aimed to examine the prevalence of LV diastolic dysfunction in each group categorized by the geometric pattern of LV hypertrophy in a community-based population. We studied 1260 community-dwelling subjects who experienced no symptoms of obvious heart disease (461 men, 799 women) and who participated in annual health check-ups in a rural Japanese community. The subjects were divided into 4 groups according to LV mass index and relative wall thickness: normal geometry, concentric remodeling, eccentric hypertrophy, and concentric hypertrophy. We investigated the prevalence of LV diastolic dysfunction in the overall and stratified population by LV geometric pattern. LV diastolic function was determined by 3 echocardiographic parameters of LV diastolic function: early diastolic myocardial velocity, the ratio of early diastolic mitral inflow velocity and myocardial velocity, and indexed left atrial dimension. LV diastolic dysfunction was defined as the presence of abnormal values in more than 2 of 3 echocardiographic parameters. The prevalence of LV diastolic dysfunction was higher in the categories with more severe LV hypertrophy. However, LV mass index, rather than relative wall thickness, was a significant determinant of LV diastolic dysfunction, after adjustment for comorbidities. In addition, 71 (10%) out of 740 subjects with normal LV geometric pattern had LV diastolic dysfunction even without obvious LV geometric change. The prevalence of LV diastolic dysfunction was higher in the subjects with more severe LV hypertrophy in a community-based population. Subclinical LV diastolic dysfunction without obvious LV geometric change should be noted and its clinical impact should be elucidated.