Effects of multiparity on left ventricular diastolic dysfunction in women: cross-sectional study of the KoRean wOmen’S chest pain rEgistry (KoROSE)

ObjectivesTo investigate the association between left ventricular (LV) diastolic dysfunction and multiparity in patients with suspected coronary artery disease (CAD).DesignCross-sectional study.SettingLinked secondary and tertiary care records from 29 cardiac centres which participated in KoRean wOm...

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Published inBMJ open Vol. 8; no. 12; p. e026968
Main Authors Kim, Hyun-Jin, Kim, Myung-A, Kim, Hack-Lyoung, Shim, Wan Joo, Park, Seong Mi, Kim, Mina, Yoon, Hyun Ju, Shin, Mi Seung, Hong, Kyung-Soon, Shin, Gil Ja, Kim, Yong-Hyun, Na, Jin Oh, Jeong, Jin-Ok
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group LTD 01.12.2018
BMJ Publishing Group
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ISSN2044-6055
2044-6055
DOI10.1136/bmjopen-2018-026968

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Abstract ObjectivesTo investigate the association between left ventricular (LV) diastolic dysfunction and multiparity in patients with suspected coronary artery disease (CAD).DesignCross-sectional study.SettingLinked secondary and tertiary care records from 29 cardiac centres which participated in KoRean wOmen’S chest pain rEgistry.Participants960 women with suspected CAD who underwent invasive coronary angiography from February 2011 to May 2017. The patients were classified by parity number, as follows: low-parity, 0 to <3; multiparity, ≥3 pregnancies.Main outcome measurePrevalence of LV diastolic dysfunction.ResultsThere were 302 and 658 low-parity and multiparity patients, respectively. The prevalence of LV diastolic dysfunction was significantly higher in the multiparity than in the low-parity group. The multiparity group had significantly lower E and e´ septal velocities and E/A ratio, and had a significantly higher E/e´ ratio and right ventricular systolic pressure, which are parameters of LV diastolic dysfunction, than the low-parity group. The prevalence of CAD was significantly higher in the multiparity than in the low-parity group. Receiver operating characteristic curve analysis identified a parity of 2.5 as the cut-off for predicting LV diastolic dysfunction (area under the curve, 0.66; sensitivity, 74.1%; specificity, 52.0%; 95% CI 0.607 to 0.706; p<0.001). After adjustment for confounding factors, multivariate regression analysis showed that multiparity had a 1.80-fold increased risk for LV diastolic dysfunction (OR 1.80, 95% CI 1.053 to 3.081, p=0.032).ConclusionsThe prevalence of LV diastolic dysfunction was higher in multiparity than in low-parity women with suspected CAD. Multiparity was an independent risk factor for LV diastolic dysfunction. LV diastolic dysfunction should be evaluated in multiparous women for the risk of subsequent cardiovascular disease and facilitate the initiation of appropriate treatment.
AbstractList ObjectivesTo investigate the association between left ventricular (LV) diastolic dysfunction and multiparity in patients with suspected coronary artery disease (CAD).DesignCross-sectional study.SettingLinked secondary and tertiary care records from 29 cardiac centres which participated in KoRean wOmen’S chest pain rEgistry.Participants960 women with suspected CAD who underwent invasive coronary angiography from February 2011 to May 2017. The patients were classified by parity number, as follows: low-parity, 0 to <3; multiparity, ≥3 pregnancies.Main outcome measurePrevalence of LV diastolic dysfunction.ResultsThere were 302 and 658 low-parity and multiparity patients, respectively. The prevalence of LV diastolic dysfunction was significantly higher in the multiparity than in the low-parity group. The multiparity group had significantly lower E and e´ septal velocities and E/A ratio, and had a significantly higher E/e´ ratio and right ventricular systolic pressure, which are parameters of LV diastolic dysfunction, than the low-parity group. The prevalence of CAD was significantly higher in the multiparity than in the low-parity group. Receiver operating characteristic curve analysis identified a parity of 2.5 as the cut-off for predicting LV diastolic dysfunction (area under the curve, 0.66; sensitivity, 74.1%; specificity, 52.0%; 95% CI 0.607 to 0.706; p<0.001). After adjustment for confounding factors, multivariate regression analysis showed that multiparity had a 1.80-fold increased risk for LV diastolic dysfunction (OR 1.80, 95% CI 1.053 to 3.081, p=0.032).ConclusionsThe prevalence of LV diastolic dysfunction was higher in multiparity than in low-parity women with suspected CAD. Multiparity was an independent risk factor for LV diastolic dysfunction. LV diastolic dysfunction should be evaluated in multiparous women for the risk of subsequent cardiovascular disease and facilitate the initiation of appropriate treatment.
To investigate the association between left ventricular (LV) diastolic dysfunction and multiparity in patients with suspected coronary artery disease (CAD). Cross-sectional study. Linked secondary and tertiary care records from 29 cardiac centres which participated in KoRean wOmen'S chest pain rEgistry. 960 women with suspected CAD who underwent invasive coronary angiography from February 2011 to May 2017. The patients were classified by parity number, as follows: low-parity, 0 to <3; multiparity, ≥3 pregnancies. Prevalence of LV diastolic dysfunction. There were 302 and 658 low-parity and multiparity patients, respectively. The prevalence of LV diastolic dysfunction was significantly higher in the multiparity than in the low-parity group. The multiparity group had significantly lower E and e´ septal velocities and E/A ratio, and had a significantly higher E/e´ ratio and right ventricular systolic pressure, which are parameters of LV diastolic dysfunction, than the low-parity group. The prevalence of CAD was significantly higher in the multiparity than in the low-parity group. Receiver operating characteristic curve analysis identified a parity of 2.5 as the cut-off for predicting LV diastolic dysfunction (area under the curve, 0.66; sensitivity, 74.1%; specificity, 52.0%; 95% CI 0.607 to 0.706; p<0.001). After adjustment for confounding factors, multivariate regression analysis showed that multiparity had a 1.80-fold increased risk for LV diastolic dysfunction (OR 1.80, 95% CI 1.053 to 3.081, p=0.032). The prevalence of LV diastolic dysfunction was higher in multiparity than in low-parity women with suspected CAD. Multiparity was an independent risk factor for LV diastolic dysfunction. LV diastolic dysfunction should be evaluated in multiparous women for the risk of subsequent cardiovascular disease and facilitate the initiation of appropriate treatment.
To investigate the association between left ventricular (LV) diastolic dysfunction and multiparity in patients with suspected coronary artery disease (CAD).OBJECTIVESTo investigate the association between left ventricular (LV) diastolic dysfunction and multiparity in patients with suspected coronary artery disease (CAD).Cross-sectional study.DESIGNCross-sectional study.Linked secondary and tertiary care records from 29 cardiac centres which participated in KoRean wOmen'S chest pain rEgistry.SETTINGLinked secondary and tertiary care records from 29 cardiac centres which participated in KoRean wOmen'S chest pain rEgistry.960 women with suspected CAD who underwent invasive coronary angiography from February 2011 to May 2017. The patients were classified by parity number, as follows: low-parity, 0 to <3; multiparity, ≥3 pregnancies.PARTICIPANTS960 women with suspected CAD who underwent invasive coronary angiography from February 2011 to May 2017. The patients were classified by parity number, as follows: low-parity, 0 to <3; multiparity, ≥3 pregnancies.Prevalence of LV diastolic dysfunction.MAIN OUTCOME MEASUREPrevalence of LV diastolic dysfunction.There were 302 and 658 low-parity and multiparity patients, respectively. The prevalence of LV diastolic dysfunction was significantly higher in the multiparity than in the low-parity group. The multiparity group had significantly lower E and e´ septal velocities and E/A ratio, and had a significantly higher E/e´ ratio and right ventricular systolic pressure, which are parameters of LV diastolic dysfunction, than the low-parity group. The prevalence of CAD was significantly higher in the multiparity than in the low-parity group. Receiver operating characteristic curve analysis identified a parity of 2.5 as the cut-off for predicting LV diastolic dysfunction (area under the curve, 0.66; sensitivity, 74.1%; specificity, 52.0%; 95% CI 0.607 to 0.706; p<0.001). After adjustment for confounding factors, multivariate regression analysis showed that multiparity had a 1.80-fold increased risk for LV diastolic dysfunction (OR 1.80, 95% CI 1.053 to 3.081, p=0.032).RESULTSThere were 302 and 658 low-parity and multiparity patients, respectively. The prevalence of LV diastolic dysfunction was significantly higher in the multiparity than in the low-parity group. The multiparity group had significantly lower E and e´ septal velocities and E/A ratio, and had a significantly higher E/e´ ratio and right ventricular systolic pressure, which are parameters of LV diastolic dysfunction, than the low-parity group. The prevalence of CAD was significantly higher in the multiparity than in the low-parity group. Receiver operating characteristic curve analysis identified a parity of 2.5 as the cut-off for predicting LV diastolic dysfunction (area under the curve, 0.66; sensitivity, 74.1%; specificity, 52.0%; 95% CI 0.607 to 0.706; p<0.001). After adjustment for confounding factors, multivariate regression analysis showed that multiparity had a 1.80-fold increased risk for LV diastolic dysfunction (OR 1.80, 95% CI 1.053 to 3.081, p=0.032).The prevalence of LV diastolic dysfunction was higher in multiparity than in low-parity women with suspected CAD. Multiparity was an independent risk factor for LV diastolic dysfunction. LV diastolic dysfunction should be evaluated in multiparous women for the risk of subsequent cardiovascular disease and facilitate the initiation of appropriate treatment.CONCLUSIONSThe prevalence of LV diastolic dysfunction was higher in multiparity than in low-parity women with suspected CAD. Multiparity was an independent risk factor for LV diastolic dysfunction. LV diastolic dysfunction should be evaluated in multiparous women for the risk of subsequent cardiovascular disease and facilitate the initiation of appropriate treatment.
Author Shim, Wan Joo
Jeong, Jin-Ok
Yoon, Hyun Ju
Kim, Hyun-Jin
Kim, Hack-Lyoung
Shin, Mi Seung
Kim, Myung-A
Park, Seong Mi
Kim, Yong-Hyun
Hong, Kyung-Soon
Kim, Mina
Na, Jin Oh
Shin, Gil Ja
AuthorAffiliation 2 Cardiovascular Center , Seoul National University Boramae Medical Hospital , Seoul , Korea
8 Department of Cardiology , Korea University Guro Hospital , Seoul , Korea
7 Department of Cardiology , Ewha Womans University Hospital , Seoul , Korea
1 Chungbuk Regional Cardiovascular Center , Chungbuk National University Hospital , Cheongju , Chungcheongbuk-do , Korea
4 Department of Cardiology , Chonnam National University Hospital , Gwangju , Korea
5 Department of Cardiology , Gachon Medical School Gil Medical Center , Incheon , Korea
9 Department of Cardiology , Chungnam National University Hospital , Daejeon , Korea
6 Department of Cardiology , Hanllym University Chuncheon Sacred Heart Hospital , Chuncheon , Korea
3 Cardiovascular Center , Korea University Anam Hospital , Seoul , Korea
AuthorAffiliation_xml – name: 8 Department of Cardiology , Korea University Guro Hospital , Seoul , Korea
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/30593559$$D View this record in MEDLINE/PubMed
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Issue 12
Keywords diastolic dysfunction
left ventricle
parity
pregnancy
Language English
License This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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PublicationDecade 2010
PublicationPlace England
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Snippet ObjectivesTo investigate the association between left ventricular (LV) diastolic dysfunction and multiparity in patients with suspected coronary artery disease...
To investigate the association between left ventricular (LV) diastolic dysfunction and multiparity in patients with suspected coronary artery disease (CAD)....
To investigate the association between left ventricular (LV) diastolic dysfunction and multiparity in patients with suspected coronary artery disease...
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StartPage e026968
SubjectTerms Age
Aged
Blood pressure
Cardiovascular disease
Cardiovascular Medicine
Coronary Angiography
Coronary vessels
Cross-Sectional Studies
Diabetes
Diastole
Female
Health risk assessment
Heart failure
Hemoglobin
Hormones
Humans
Hypertension
Laboratories
Medical imaging
Metabolic syndrome
Middle Aged
Mortality
Multivariate Analysis
Pain
Parity
Physiology
Population
Pregnancy
Pregnancy Complications, Cardiovascular
Registries
Regression Analysis
Republic of Korea - epidemiology
ROC Curve
Velocity
Ventricular Dysfunction, Left - epidemiology
Ventricular Dysfunction, Left - physiopathology
Ventricular Function, Left
Womens health
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Title Effects of multiparity on left ventricular diastolic dysfunction in women: cross-sectional study of the KoRean wOmen’S chest pain rEgistry (KoROSE)
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