Contemporary Assessment of Left Ventricular Diastolic Function in Older Adults: The Atherosclerosis Risk in Communities Study
Authors' conclusion
Our findings suggest that left ventricular longitudinal relaxation velocity declines as a part of healthy aging and is largely prognostically benign. The use of age-based normative values when considering an elderly population improves the risk discrimination of diastolic measures for incident HF or death.
Study context
- Population
- Elderly participants in the ARIC study (age 67–90 years; mean 76±5 years; 42% male; 21% black)reference sample n = 401
- Participants
- 5,801 participants
- Exposure
- ARIC-based limits vs Guideline cut points
- Outcome
- HF hospitalization or death
Methodological detailscommunity-based, external replication cohort
- Community-based
- External replication cohort
Main finding
As reported in the abstract
Reference limits for TDI e' and risk discrimination for incident HF or death
| Group | Septal TDI e' | Lateral TDI e' |
|---|---|---|
| ARIC-based limits | 4.6 cm/s | 5.2 cm/s |
| Guideline cut points | 7 cm/s | 10 cm/s |
Septal TDI e'
ARIC-based limits4.6 cm/s
Guideline cut points7 cm/s
Lateral TDI e'
ARIC-based limits5.2 cm/s
Guideline cut points10 cm/s
- ARIC-based limits vs Guideline cut points: P < 0.001
- ARIC-based limits vs Guideline cut points: P < 0.001 — 42% reclassified as normal diastolic function
Observational data: associations, not effects.
Further findings
Heart failure (HF) hospitalization or death by number of abnormal diastolic measures (ARIC-based limits) · mean 1.7-year follow-up
- Normal diastolic function (46%): low risk
- 1%/y
- 1 or 2 abnormal measures (49%): intermediate risk
- 2.4%/y
- All 3 measures abnormal (5%): high risk
- 7.5%/y
Original publication
Contemporary Assessment of Left Ventricular Diastolic Function in Older Adults: The Atherosclerosis Risk in Communities Study. Circulation. Published 7 December 2016. doi:10.
Summarised from the published abstract; every number is checked against it