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      Prevalence and Predictors of Diastolic Dysfunction According to Different Classification Criteria : The Coronary Artery Risk Development in Young in Adults Study

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          Abstract

          Heart failure with preserved ejection fraction is often preceded by diastolic dysfunction (DD). Of several published DD criteria, it is unclear which, if any, are applicable to data obtained in epidemiologic cohorts. We evaluated the prevalence of DD using previously published definitions in a population-based study, the Coronary Artery Risk Development in Young Adults (CARDIA) Study, using data gathered in 2010–2011. Echocardiography was performed on 3,474 individuals (mean age = 50.2 years) at the CARDIA year 25 examination. Four published definitions of DD were studied. We calculated DD prevalence for each definition and determined the overlap between definitions. We used logistic regression to assess the strength of associations between demographic and clinical factors and the definitions of DD. Prevalence of DD ranged from 2% to 32% across the 4 definitions, with a minority of cases identified by more than 1 definition. Two definitions classified 38%–39% of the study sample as indeterminate for DD. Associations of risk factors with DD varied considerably, with male sex being associated positively with DD for one definition (odds ratio = 1.4, 95% confidence interval: 1.2, 1.6) and inversely for another (odds ratio = 0.7, 95% confidence interval: 0.6, 0.8). Prevalence of DD varies markedly in CARDIA by the definition applied. A uniform, reliable, and accurate definition of DD for epidemiologic studies is needed.

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          Author and article information

          Journal
          Am J Epidemiol
          Am. J. Epidemiol
          aje
          American Journal of Epidemiology
          Oxford University Press
          0002-9262
          1476-6256
          15 June 2017
          27 April 2017
          15 June 2018
          : 185
          : 12
          : 1221-1227
          Affiliations
          [kww2141 ]Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
          [kww2142 ]Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
          [kww2143 ]Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
          [kww2144 ]Department of Medicine and Public Health Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
          [kww2145 ]A. I. DuPont Hospital for Children, Wilmington, Delaware
          [kww2146 ]Division of Cardiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
          Author notes
          [* ]Correspondence to Dr. Laura J. Rasmussen-Torvik, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL 60611 (e-mail: ljrtorvik@ 123456northwestern.edu ).
          Abbreviations: ASE, American Society of Echocardiography; CARDIA, Coronary Artery Risk Development in Young Adults; DD, diastolic dysfunction; VALIDD, Valsartan in Diastolic Dysfunction.
          Article
          PMC5860331 PMC5860331 5860331 kww214
          10.1093/aje/kww214
          5860331
          28453616
          79c41302-af76-4599-b5a8-b9d6124e2e32
          © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
          History
          : 23 February 2016
          : 16 June 2016
          : 20 July 2016
          Page count
          Pages: 7
          Funding
          Funded by: National Heart, Lung, and Blood Institute (NHLBI) 10.13039/100000050
          Funded by: National Institute on Aging 10.13039/100000049
          Funded by: Intramural Research Program of the National Institute on Aging (NIA)
          Funded by: NIA
          Funded by: NHLBI 10.13039/100000050
          Award ID: AG0005
          Categories
          Practice of Epidemiology

          epidemiologic methods,diastolic dysfunction,echocardiography,heart failure

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