Premature Cardiac Aging in South Asian Compared to Afro‐Caribbean Subjects in a Community‐Based Screening Study

BACKGROUND: People of South Asian (SAs) and African Caribbean (AC) origin have increased cardiovascular morbidity, but underlying mechanisms are poorly understood. Aging is the key predictor of deterioration in diastolic function, which can be assessed by echocardiography using E/e′ ratio as a surro...

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Autores principales: Shantsila, Eduard, Shantsila, Alena, Gill, Paramjit S., Lip, Gregory Y.H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5210345/
https://www.ncbi.nlm.nih.gov/pubmed/27930355
http://dx.doi.org/10.1161/JAHA.116.004110
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author Shantsila, Eduard
Shantsila, Alena
Gill, Paramjit S.
Lip, Gregory Y.H.
author_facet Shantsila, Eduard
Shantsila, Alena
Gill, Paramjit S.
Lip, Gregory Y.H.
author_sort Shantsila, Eduard
collection PubMed
description BACKGROUND: People of South Asian (SAs) and African Caribbean (AC) origin have increased cardiovascular morbidity, but underlying mechanisms are poorly understood. Aging is the key predictor of deterioration in diastolic function, which can be assessed by echocardiography using E/e′ ratio as a surrogate of left ventricular (LV) filling pressure. The study aimed to assess a possibility of premature cardiac aging in SA and AC subjects. METHODS AND RESULTS: We studied 4540 subjects: 2880 SA and 1660 AC subjects. All participants underwent detailed echocardiography, including LV ejection fraction, average septal‐lateral E/e′, and LV mass index (LVMI). When compared to ACs, SAs were younger, with lower mean LVMI, systolic blood pressure (BP), diastolic BP, and body mass index (BMI), as well as a lower prevalence of hypertension and smoking (P≤0.001 for all). In a multivariate linear regression model including age, sex, ethnicity, BP, heart rate, BMI, waist circumference, LVMI, history of smoking, hypertension, coronary artery disease, diabetes mellitus, medications, SA origin was independently associated with higher E/e′ (regression coefficient±standard error, −0.66±0.10; P<0.001, adjusted R (2) for the model 0.21; P<0.001). Furthermore, SAs had significantly accelerated age‐dependent increase in E/e′ compared to ACs. On multivariable Cox regression analysis without adjustment for E/e′, SA ethnicity was independently predictive of mortality (P=0.04). After additional adjustment for E/e′, the ethnicity lost its significance value, whereas E/e′ was independently predictive of higher risk of death (P=0.008). CONCLUSIONS: Premature cardiac aging is evident in SAs and may contribute to high cardiovascular morbidity in this ethnic group, compared to ACs.
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spelling pubmed-52103452017-01-05 Premature Cardiac Aging in South Asian Compared to Afro‐Caribbean Subjects in a Community‐Based Screening Study Shantsila, Eduard Shantsila, Alena Gill, Paramjit S. Lip, Gregory Y.H. J Am Heart Assoc Original Research BACKGROUND: People of South Asian (SAs) and African Caribbean (AC) origin have increased cardiovascular morbidity, but underlying mechanisms are poorly understood. Aging is the key predictor of deterioration in diastolic function, which can be assessed by echocardiography using E/e′ ratio as a surrogate of left ventricular (LV) filling pressure. The study aimed to assess a possibility of premature cardiac aging in SA and AC subjects. METHODS AND RESULTS: We studied 4540 subjects: 2880 SA and 1660 AC subjects. All participants underwent detailed echocardiography, including LV ejection fraction, average septal‐lateral E/e′, and LV mass index (LVMI). When compared to ACs, SAs were younger, with lower mean LVMI, systolic blood pressure (BP), diastolic BP, and body mass index (BMI), as well as a lower prevalence of hypertension and smoking (P≤0.001 for all). In a multivariate linear regression model including age, sex, ethnicity, BP, heart rate, BMI, waist circumference, LVMI, history of smoking, hypertension, coronary artery disease, diabetes mellitus, medications, SA origin was independently associated with higher E/e′ (regression coefficient±standard error, −0.66±0.10; P<0.001, adjusted R (2) for the model 0.21; P<0.001). Furthermore, SAs had significantly accelerated age‐dependent increase in E/e′ compared to ACs. On multivariable Cox regression analysis without adjustment for E/e′, SA ethnicity was independently predictive of mortality (P=0.04). After additional adjustment for E/e′, the ethnicity lost its significance value, whereas E/e′ was independently predictive of higher risk of death (P=0.008). CONCLUSIONS: Premature cardiac aging is evident in SAs and may contribute to high cardiovascular morbidity in this ethnic group, compared to ACs. John Wiley and Sons Inc. 2016-11-10 /pmc/articles/PMC5210345/ /pubmed/27930355 http://dx.doi.org/10.1161/JAHA.116.004110 Text en © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Shantsila, Eduard
Shantsila, Alena
Gill, Paramjit S.
Lip, Gregory Y.H.
Premature Cardiac Aging in South Asian Compared to Afro‐Caribbean Subjects in a Community‐Based Screening Study
title Premature Cardiac Aging in South Asian Compared to Afro‐Caribbean Subjects in a Community‐Based Screening Study
title_full Premature Cardiac Aging in South Asian Compared to Afro‐Caribbean Subjects in a Community‐Based Screening Study
title_fullStr Premature Cardiac Aging in South Asian Compared to Afro‐Caribbean Subjects in a Community‐Based Screening Study
title_full_unstemmed Premature Cardiac Aging in South Asian Compared to Afro‐Caribbean Subjects in a Community‐Based Screening Study
title_short Premature Cardiac Aging in South Asian Compared to Afro‐Caribbean Subjects in a Community‐Based Screening Study
title_sort premature cardiac aging in south asian compared to afro‐caribbean subjects in a community‐based screening study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5210345/
https://www.ncbi.nlm.nih.gov/pubmed/27930355
http://dx.doi.org/10.1161/JAHA.116.004110
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