Diastolic dysfunction can be caused by hypertension or diabetes mellitus, and it is also often found with increasing age. In a given patient, the cause of diastolic dysfunction is therefore not always obvious. We sought to study the interplay of these risk factors for diastolic dysfunction in an outpatient population with a low likelihood of ischemic heart disease. Consecutive patients referred for stress echocardiography were included retrospectively. Exclusion criteria included pathological stress response, atrial arrhythmia, left ventricular ejection fraction < 55%, and more than mild valvular disease. Standard diastolic parameters were recorded in all patients. In a subset of patients, mechanistic analysis of early filling was performed using the parameterized diastolic filling (PDF) method. We included 726 patients (median [interquartile range] age 56 (44–65) years, 57% male). The prevalence of diabetes and hypertension was 43 and 49%, respectively. In multiple linear regression modeling, the presence of diabetes, hypertension, sex and increasing age explained a moderate amount of the variance in e’ velocities, E/A ratio and E/e’ (R2 = 0.31–0.48, p < 0.001), and a low amount of the variance in left atrial volume index (LAVI) and the PDF parameters (n = 446, R2 = 0.05–0.17, p < 0.001). Sex was only related to LAVI and E/e’ for the conventional parameters (beta − 0.94, p = 0.04, and beta − 0.91, p < 0.001, respectively). Diabetes, hypertension, increasing age, and to a lesser extent sex, explain a moderate amount of the variance in conventional diastolic parameters related to myocardial tissue velocities and E/A ratio in a healthy outpatient population. The effect of these risk factors was substantially less pronounced on left atrial volume index and the PDF parameters.

中文翻译：

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负荷超声心动图检查结果正常的门诊患者舒张功能及其与糖尿病、高血压和年龄的关系

舒张功能障碍可由高血压或糖尿病引起，并且随着年龄的增长也经常发现。因此，在特定患者中，舒张功能障碍的原因并不总是很明显。我们试图在缺血性心脏病可能性较低的门诊人群中研究这些舒张功能障碍风险因素的相互作用。回顾性包括连续转诊进行负荷超声心动图检查的患者。排除标准包括病理性应激反应、房性心律失常、左心室射血分数 < 55% 和轻度以上的瓣膜病。记录所有患者的标准舒张参数。在一部分患者中，使用参数化舒张充盈 (PDF) 方法对早期充盈进行了机械分析。我们纳入了 726 名患者（中位 [四分位距] 年龄 56 (44–65) 岁，57% 为男性）。糖尿病和高血压的患病率分别为 43% 和 49%。在多元线性回归模型中，糖尿病、高血压、性别和年龄增长的存在解释了 e' 速度、E/A 比和 E/e' 的适度差异（R2 = 0.31–0.48，p < 0.001），以及左心房容积指数 (LAVI) 和 PDF 参数（n = 446，R2 = 0.05–0.17，p < 0.001）的少量差异。对于常规参数，性别仅与 LAVI 和 E/e' 相关（分别为 beta - 0.94，p = 0.04 和 beta - 0.91，p < 0.001）。糖尿病、高血压、年龄增长，以及在较小程度上的性别，解释了在健康门诊人群中与心肌组织速度和 E/A 比相关的常规舒张参数的适度差异。这些风险因素对左心房容积指数和 PDF 参数的影响明显不那么明显。