Prevalence and Predictors of Diastolic Dysfunction According to Different Classification Criteria

Laura J. Rasmussen-Torvik, Laura A. Colangelo, Joao A.C. Lima, David R. Jacobs, Carlos J. Rodriguez, Samuel S. Gidding, Donald M. Lloyd-Jones, Sanjiv J. Shah

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1221-1227
Number of pages7
JournalAmerican journal of epidemiology
Issue number12
StatePublished - Jun 15 2017

Bibliographical note

Funding Information:
This work was supported by contracts HHSN268201300025C, HHSN268201300026C, HHSN268201300027C, HHSN268201300028C, HHSN268201300029C, and HHSN268200900041C from the National Heart, Lung, and Blood Institute (NHLBI), the Intramural Research Program of the National Institute on Aging (NIA), and an intraagency agreement between the NIA and the NHLBI (agreement AG0005), all of which fund the Coronary Artery Risk Development in Young Adults Study.

Publisher Copyright:
© The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved.


  • diastolic dysfunction
  • echocardiography
  • epidemiologic methods
  • heart failure


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