Abstract 15586: Performance of Two Echocardiographic Schema for Grading Diastolic Dysfunction in An Elderly Community-Based Cohort Free of Heart Failure - An Analysis of 2,798 Participants from the ARIC Study
Background: Age-related changes in structural and Doppler measures of diastolic dysfunction (DD) are well recognized, however data regarding the performance of current DD grading schema in the elderly are limited. We characterized the frequency and correlates of DD by current grading schema in a biracial elderly cohort.
Methods: Quantitative echocardiographic analysis was performed at a core laboratory in 2,798 elderly participants in the Atherosclerosis Risk in Communities (ARIC) study, who were free of significant valvular disease or prior heart failure (HF). Diastolic function was assessed by mitral inflow Doppler (E, A wave velocities), E wave deceleration time, tissue Doppler early diastolic mitral annular velocity (E’), E/E’ ratio, and left atrial volume index (LAVi). DD was graded by both the Olmsted and American Society of Echocardiography (ASE) criteria.
Results: Mean age was 75±5 years, 58% were women, 79% white, 61% had hypertension, 28% diabetes, and 10% CHD. Mean LVEF was 66±6%. DD grade was classifiable in 99.7% of participants using the Olmsted criteria, with only 15% demonstrating normal diastolic function (Figure). In contrast, 77% of participants were unclassifiable using the ASE criteria, primarily due to discordant LAVi (22.2±6.3 ml/m2) and E’(lateral: 6.7±1.6; septal: 5.5±1.1 cm/s). Worse DD grade by both criteria was associated with older age, hypertension, higher LV mass index, higher tricuspid regurgitation jet velocity, lower TDI S’ (p<0.01 for all) and lower LVEF (p≤0.03).
Conclusions: Among elderly persons without HF in the general population, the large majority were classified as having DD by the Olmsted scheme while the majority was unclassifiable by the ASE criteria. Our results suggest the need for tailored application or modification of DD grading schema in the elderly.
- © 2012 by American Heart Association, Inc.