Race-ethnic differences in subclinical left ventricular systolic dysfunction by global longitudinal strain

A community-based cohort study

Cesare Russo, Zhezhen Jin, Shunichi Homma, Tatjana Rundek, Mitchell S.V. Elkind, Ralph L Sacco, Marco R. Di Tullio

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Race-ethnic differences exist in the epidemiology of heart failure, with blacks experiencing higher incidence and worse prognosis. Left ventricular (LV) systolic dysfunction (LVSD) detected by speckle-tracking global longitudinal strain (GLS) is a predictor of cardiovascular events including heart failure. It is not known whether race-ethnic differences in GLS-LVSD exist in subjects without overt LV dysfunction. Methods: Participants from a triethnic community-based study underwent 2-dimensional echocardiography with assessment of LV ejection fraction (LVEF) and GLS by speckle-tracking. Participants with LVEF <50% were excluded. Left ventricular systolic dysfunction by GLS was defined as GLS >95% percentile in a healthy sample (-14.7%). Results: Of the 678 study participants (mean age 71 ± 9 years, 61% women), 114 were blacks; 464, Hispanics; and 100, whites. Global longitudinal strain was significantly lower in blacks (-16.5% ± 3.5%) than in whites (-17.5% ± 3.0%) and Hispanics (-17.3% ± 2.9%) in both univariate (P = .015) and multivariate analyses (P = .011), whereas LVEF was not significantly different between the 3 groups (64.3% ± 4.6%, 63.4% ± 4.9%, 64.7% ± 4.9%, respectively, univariate P = .064, multivariate P = .291). Left ventricular systolic dysfunction by GLS was more frequent in blacks (27.2%) than in whites (19.0%) and Hispanics (14.9%, P = .008). In multivariate analysis adjusted for confounders and cardiovascular risk factors, blacks were significantly more likely to have GLS-LVSD (adjusted odds ratio 2.6, 95% CIs 1.4-4.7, P = .002) compared to the other groups. Conclusions: Among participants from a triethnic community cohort, black race was associated with greater degree of subclinical LVSD by GLS than other race-ethnic groups. This difference was independent of confounders and cardiovascular risk factors.

Original languageEnglish
JournalAmerican Heart Journal
DOIs
StateAccepted/In press - Nov 3 2014

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Left Ventricular Dysfunction
Cohort Studies
Hispanic Americans
Multivariate Analysis
Heart Failure
Ethnic Groups
Stroke Volume
Echocardiography
Epidemiology
Odds Ratio
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Race-ethnic differences in subclinical left ventricular systolic dysfunction by global longitudinal strain : A community-based cohort study. / Russo, Cesare; Jin, Zhezhen; Homma, Shunichi; Rundek, Tatjana; Elkind, Mitchell S.V.; Sacco, Ralph L; Di Tullio, Marco R.

In: American Heart Journal, 03.11.2014.

Research output: Contribution to journalArticle

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title = "Race-ethnic differences in subclinical left ventricular systolic dysfunction by global longitudinal strain: A community-based cohort study",
abstract = "Race-ethnic differences exist in the epidemiology of heart failure, with blacks experiencing higher incidence and worse prognosis. Left ventricular (LV) systolic dysfunction (LVSD) detected by speckle-tracking global longitudinal strain (GLS) is a predictor of cardiovascular events including heart failure. It is not known whether race-ethnic differences in GLS-LVSD exist in subjects without overt LV dysfunction. Methods: Participants from a triethnic community-based study underwent 2-dimensional echocardiography with assessment of LV ejection fraction (LVEF) and GLS by speckle-tracking. Participants with LVEF <50{\%} were excluded. Left ventricular systolic dysfunction by GLS was defined as GLS >95{\%} percentile in a healthy sample (-14.7{\%}). Results: Of the 678 study participants (mean age 71 ± 9 years, 61{\%} women), 114 were blacks; 464, Hispanics; and 100, whites. Global longitudinal strain was significantly lower in blacks (-16.5{\%} ± 3.5{\%}) than in whites (-17.5{\%} ± 3.0{\%}) and Hispanics (-17.3{\%} ± 2.9{\%}) in both univariate (P = .015) and multivariate analyses (P = .011), whereas LVEF was not significantly different between the 3 groups (64.3{\%} ± 4.6{\%}, 63.4{\%} ± 4.9{\%}, 64.7{\%} ± 4.9{\%}, respectively, univariate P = .064, multivariate P = .291). Left ventricular systolic dysfunction by GLS was more frequent in blacks (27.2{\%}) than in whites (19.0{\%}) and Hispanics (14.9{\%}, P = .008). In multivariate analysis adjusted for confounders and cardiovascular risk factors, blacks were significantly more likely to have GLS-LVSD (adjusted odds ratio 2.6, 95{\%} CIs 1.4-4.7, P = .002) compared to the other groups. Conclusions: Among participants from a triethnic community cohort, black race was associated with greater degree of subclinical LVSD by GLS than other race-ethnic groups. This difference was independent of confounders and cardiovascular risk factors.",
author = "Cesare Russo and Zhezhen Jin and Shunichi Homma and Tatjana Rundek and Elkind, {Mitchell S.V.} and Sacco, {Ralph L} and {Di Tullio}, {Marco R.}",
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AU - Rundek, Tatjana

AU - Elkind, Mitchell S.V.

AU - Sacco, Ralph L

AU - Di Tullio, Marco R.

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N2 - Race-ethnic differences exist in the epidemiology of heart failure, with blacks experiencing higher incidence and worse prognosis. Left ventricular (LV) systolic dysfunction (LVSD) detected by speckle-tracking global longitudinal strain (GLS) is a predictor of cardiovascular events including heart failure. It is not known whether race-ethnic differences in GLS-LVSD exist in subjects without overt LV dysfunction. Methods: Participants from a triethnic community-based study underwent 2-dimensional echocardiography with assessment of LV ejection fraction (LVEF) and GLS by speckle-tracking. Participants with LVEF <50% were excluded. Left ventricular systolic dysfunction by GLS was defined as GLS >95% percentile in a healthy sample (-14.7%). Results: Of the 678 study participants (mean age 71 ± 9 years, 61% women), 114 were blacks; 464, Hispanics; and 100, whites. Global longitudinal strain was significantly lower in blacks (-16.5% ± 3.5%) than in whites (-17.5% ± 3.0%) and Hispanics (-17.3% ± 2.9%) in both univariate (P = .015) and multivariate analyses (P = .011), whereas LVEF was not significantly different between the 3 groups (64.3% ± 4.6%, 63.4% ± 4.9%, 64.7% ± 4.9%, respectively, univariate P = .064, multivariate P = .291). Left ventricular systolic dysfunction by GLS was more frequent in blacks (27.2%) than in whites (19.0%) and Hispanics (14.9%, P = .008). In multivariate analysis adjusted for confounders and cardiovascular risk factors, blacks were significantly more likely to have GLS-LVSD (adjusted odds ratio 2.6, 95% CIs 1.4-4.7, P = .002) compared to the other groups. Conclusions: Among participants from a triethnic community cohort, black race was associated with greater degree of subclinical LVSD by GLS than other race-ethnic groups. This difference was independent of confounders and cardiovascular risk factors.

AB - Race-ethnic differences exist in the epidemiology of heart failure, with blacks experiencing higher incidence and worse prognosis. Left ventricular (LV) systolic dysfunction (LVSD) detected by speckle-tracking global longitudinal strain (GLS) is a predictor of cardiovascular events including heart failure. It is not known whether race-ethnic differences in GLS-LVSD exist in subjects without overt LV dysfunction. Methods: Participants from a triethnic community-based study underwent 2-dimensional echocardiography with assessment of LV ejection fraction (LVEF) and GLS by speckle-tracking. Participants with LVEF <50% were excluded. Left ventricular systolic dysfunction by GLS was defined as GLS >95% percentile in a healthy sample (-14.7%). Results: Of the 678 study participants (mean age 71 ± 9 years, 61% women), 114 were blacks; 464, Hispanics; and 100, whites. Global longitudinal strain was significantly lower in blacks (-16.5% ± 3.5%) than in whites (-17.5% ± 3.0%) and Hispanics (-17.3% ± 2.9%) in both univariate (P = .015) and multivariate analyses (P = .011), whereas LVEF was not significantly different between the 3 groups (64.3% ± 4.6%, 63.4% ± 4.9%, 64.7% ± 4.9%, respectively, univariate P = .064, multivariate P = .291). Left ventricular systolic dysfunction by GLS was more frequent in blacks (27.2%) than in whites (19.0%) and Hispanics (14.9%, P = .008). In multivariate analysis adjusted for confounders and cardiovascular risk factors, blacks were significantly more likely to have GLS-LVSD (adjusted odds ratio 2.6, 95% CIs 1.4-4.7, P = .002) compared to the other groups. Conclusions: Among participants from a triethnic community cohort, black race was associated with greater degree of subclinical LVSD by GLS than other race-ethnic groups. This difference was independent of confounders and cardiovascular risk factors.

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