Echocardiography E/A Abnormality is Associated with the Development of Primary Left Ventricle Remodeling in Middle-Aged and Elderly Women: A Longitudinal Study.

Clin Interv Aging

Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, People's Republic of China.

Published: April 2023

AI Article Synopsis

  • Impaired left ventricular (LV) relaxation, marked by a low E/A ratio, is linked to grade I diastolic dysfunction and may lead to LV remodeling, though the exact connection is not well understood.
  • A study analyzing 869 women aged 45 and older found that 18.9% developed LV remodeling over five years, with a significant difference in E/A abnormality rates between those who did and did not remodel.
  • The findings suggest that women with E/A abnormalities are at a higher risk of developing concentric hypertrophy (CH), while a higher baseline E/A ratio correlates with reduced changes in relative wall thickness during follow-up.

Article Abstract

Background: Impaired left ventricular (LV) relaxation is indicative of grade I diastolic dysfunction, which is mainly assessed by late diastolic transmitral flow velocity (E/A ratio). Although the E/A ratio has important diagnostic and prognostic implications with cardiac outcomes, the causal link between abnormal E/A ratio and left ventricle remodeling (LV remodeling) remains unclear.

Methods: A longitudinal analysis of 869 eligible women aged ≥45 years, who had received echocardiography scans as well as 5-year follow-up assessments between 2015 and 2020. Women with pre-existing cardiac abnormalities including grade II/III diastolic dysfunction as diagnosed by echocardiography, or structural heart disease were excluded. E/A abnormality was defined as baseline E/A ratio <0.8. The classification of LV remodeling was based on the measurements of left ventricular mass index (LVMI) and relative wall thickness (RWT). Logistic and linear regression models were used.

Results: Among the 869 women (60.71±10.01 years), 164 (18.9%) had developed LV remodeling after the 5-year follow-up. The proportion of women with E/A abnormality versus non-abnormality was also significantly different (27.13% vs 16.59%, P=0.007). Multivariable-adjusted regression models showed that E/A abnormality (OR: 4.14, 95%Cl:1.80-9.20, P=0.009) was significantly associated with higher risk of concentric hypertrophy (CH) after follow-up. No such association was found in either concentric remodeling (CR) or eccentric hypertrophy (EH). Higher baseline E/A ratio was correlated with lower ΔRWT during the 5-year follow-up (β=-0.006 m/s, 95% CI: -0.012 to -0.002, P=0.025), which was independent of demographics and biological factors.

Conclusion: E/A abnormality is associated with a higher risk of CH. Higher baseline E/A ratio may be associated with decreased relative changes in RWT.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122471PMC
http://dx.doi.org/10.2147/CIA.S399996DOI Listing

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