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Published in: European Journal of Epidemiology 4/2018

Open Access 01-04-2018 | CARDIOVASCULAR DISEASE

Measures of subclinical cardiac dysfunction and increased filling pressures associate with pulmonary arterial pressure in the general population: results from the population-based Rotterdam Study

Authors: Ryan J. Billar, Maarten J. G. Leening, Daphne Merkus, Guy G. O. Brusselle, Albert Hofman, Bruno H. Ch. Stricker, H. Ardeschir Ghofrani, Oscar H. Franco, Henning Gall, Janine F. Felix

Published in: European Journal of Epidemiology | Issue 4/2018

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Abstract

Pulmonary hypertension is associated with increased mortality and morbidity in the elderly population. Heart failure is a common cause of pulmonary hypertension. Yet, the relation between left heart parameters reflective of subclinical cardiac dysfunction and increased filling pressures, and pulmonary arterial pressures in the elderly population remains elusive. Within the population-based Rotterdam Study, 2592 unselected participants with a mean age of 72.6 years (61.4% women) had complete echocardiography data available. We studied the cross-sectional associations of left heart structure and systolic and diastolic function with echocardiographically measured pulmonary artery systolic pressure. Mean pulmonary artery systolic pressure was 25.4 mmHg. After multivariable-adjustment measures of both structure and function were independently associated with pulmonary artery systolic pressure: E/A ratio [0.63 mmHg (95% CI 0.35–0.91) per 1-SD increase], left atrial diameter [0.79 mmHg (0.50–1.09) per 1-SD increase], E/E′ ratio [1.27 mmHg (0.92–1.61) per 1-SD increase], left ventricular volume [0.62 mmHg (0.25–0.98) per 1-SD increase], fractional shortening [0.45 mmHg (0.17–0.74) per 1-SD increase], aortic root diameter [− 0.43 mmHg (− 0.72 to − 0.14) per 1-SD increase], mitral valve deceleration time [− 0.31 mmHg (− 0.57 to − 0.05) per 1-SD increase], and E′ [1.04 mmHg (0.66–1.42) per 1-SD increase]. Results did not materially differ when restricting the analyses to participants free of symptoms of shortness of breath. Structural and functional echocardiographic parameters of subclinical cardiac dysfunction and increased filling pressures are associated with pulmonary arterial pressures in the unselected general ageing population.
Literature
1.
go back to reference Galie N, Hoeper MM, Humbert M, Torbicki A, Vachiery JL, Barbera JA, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J. 2009;30(20):2493–537. https://doi.org/10.1093/eurheartj/ehp297.CrossRefPubMed Galie N, Hoeper MM, Humbert M, Torbicki A, Vachiery JL, Barbera JA, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J. 2009;30(20):2493–537. https://​doi.​org/​10.​1093/​eurheartj/​ehp297.CrossRefPubMed
2.
go back to reference McLaughlin VV, Archer SL, Badesch DB, Barst RJ, Farber HW, Lindner JR, et al. ACCF/AHA 2009 expert consensus document on pulmonary hypertension a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association developed in collaboration with the American College of Chest Physicians; American Thoracic Society, Inc.; and the Pulmonary Hypertension Association. J Am Coll Cardiol. 2009;53(17):1573–619. https://doi.org/10.1016/j.jacc.2009.01.004.CrossRefPubMed McLaughlin VV, Archer SL, Badesch DB, Barst RJ, Farber HW, Lindner JR, et al. ACCF/AHA 2009 expert consensus document on pulmonary hypertension a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association developed in collaboration with the American College of Chest Physicians; American Thoracic Society, Inc.; and the Pulmonary Hypertension Association. J Am Coll Cardiol. 2009;53(17):1573–619. https://​doi.​org/​10.​1016/​j.​jacc.​2009.​01.​004.CrossRefPubMed
7.
go back to reference Hofman A, Grobbee DE, de Jong PT, van den Ouweland FA. Determinants of disease and disability in the elderly: the Rotterdam Elderly Study. Eur J Epidemiol. 1991;7(4):403–22.CrossRefPubMed Hofman A, Grobbee DE, de Jong PT, van den Ouweland FA. Determinants of disease and disability in the elderly: the Rotterdam Elderly Study. Eur J Epidemiol. 1991;7(4):403–22.CrossRefPubMed
10.
go back to reference Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol. 1986;57(6):450–8.CrossRefPubMed Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol. 1986;57(6):450–8.CrossRefPubMed
11.
go back to reference Teichholz LE, Kreulen T, Herman MV, Gorlin R. Problems in echocardiographic volume determinations: echocardiographic–angiographic correlations in the presence of absence of asynergy. Am J Cardiol. 1976;37(1):7–11.CrossRefPubMed Teichholz LE, Kreulen T, Herman MV, Gorlin R. Problems in echocardiographic volume determinations: echocardiographic–angiographic correlations in the presence of absence of asynergy. Am J Cardiol. 1976;37(1):7–11.CrossRefPubMed
12.
go back to reference Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H, et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr. 1989;2(5):358–67.CrossRefPubMed Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H, et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr. 1989;2(5):358–67.CrossRefPubMed
13.
go back to reference Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23(7):685–713. https://doi.org/10.1016/j.echo.2010.05.010.CrossRefPubMed Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23(7):685–713. https://​doi.​org/​10.​1016/​j.​echo.​2010.​05.​010.CrossRefPubMed
14.
go back to reference New York Heart Association. Diseases of the heart and blood vessels: nomenclature and criteria for diagnosis. 6th ed. Boston: Little; 1964. New York Heart Association. Diseases of the heart and blood vessels: nomenclature and criteria for diagnosis. 6th ed. Boston: Little; 1964.
16.
go back to reference World Health Organization. ATC/DDD Index 2017. World Health Organization. ATC/DDD Index 2017.
17.
go back to reference Ommen SR, Nishimura RA. A clinical approach to the assessment of left ventricular diastolic function by Doppler echocardiography: update 2003. Heart. 2003;89(Suppl 3):iii18–23. Ommen SR, Nishimura RA. A clinical approach to the assessment of left ventricular diastolic function by Doppler echocardiography: update 2003. Heart. 2003;89(Suppl 3):iii18–23.
18.
go back to reference Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3rd, Dokainish H, Edvardsen T, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2016;17(12):1321–60. https://doi.org/10.1093/ehjci/jew082.CrossRefPubMed Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3rd, Dokainish H, Edvardsen T, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2016;17(12):1321–60. https://​doi.​org/​10.​1093/​ehjci/​jew082.CrossRefPubMed
19.
go back to reference Vasan RS, Larson MG, Levy D. Determinants of echocardiographic aortic root size. the Framingham Heart Study. Circulation. 1995;91(3):734–40.CrossRefPubMed Vasan RS, Larson MG, Levy D. Determinants of echocardiographic aortic root size. the Framingham Heart Study. Circulation. 1995;91(3):734–40.CrossRefPubMed
24.
go back to reference SOLVD Investigators, Yusuf S, Pitt B, Davis CE, Hood WB Jr, Cohn JN. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med. 1992;327(10):685–91.CrossRef SOLVD Investigators, Yusuf S, Pitt B, Davis CE, Hood WB Jr, Cohn JN. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med. 1992;327(10):685–91.CrossRef
Metadata
Title
Measures of subclinical cardiac dysfunction and increased filling pressures associate with pulmonary arterial pressure in the general population: results from the population-based Rotterdam Study
Authors
Ryan J. Billar
Maarten J. G. Leening
Daphne Merkus
Guy G. O. Brusselle
Albert Hofman
Bruno H. Ch. Stricker
H. Ardeschir Ghofrani
Oscar H. Franco
Henning Gall
Janine F. Felix
Publication date
01-04-2018
Publisher
Springer Netherlands
Published in
European Journal of Epidemiology / Issue 4/2018
Print ISSN: 0393-2990
Electronic ISSN: 1573-7284
DOI
https://doi.org/10.1007/s10654-017-0341-0

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