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 in | BMJ open Vol. 8; no. 12; p. e026968 |
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Main Authors | , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
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BMJ Publishing Group LTD
01.12.2018
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ISSN | 2044-6055 2044-6055 |
DOI | 10.1136/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. |
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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 – name: 1 Chungbuk Regional Cardiovascular Center , Chungbuk National University Hospital , Cheongju , Chungcheongbuk-do , Korea – name: 6 Department of Cardiology , Hanllym University Chuncheon Sacred Heart Hospital , Chuncheon , Korea – name: 7 Department of Cardiology , Ewha Womans University Hospital , Seoul , Korea – name: 9 Department of Cardiology , Chungnam National University Hospital , Daejeon , Korea – name: 5 Department of Cardiology , Gachon Medical School Gil Medical Center , Incheon , Korea – name: 2 Cardiovascular Center , Seoul National University Boramae Medical Hospital , Seoul , Korea – name: 4 Department of Cardiology , Chonnam National University Hospital , Gwangju , Korea – name: 3 Cardiovascular Center , Korea University Anam Hospital , Seoul , Korea |
Author_xml | – sequence: 1 givenname: Hyun-Jin surname: Kim fullname: Kim, Hyun-Jin email: kma@snu.ac.kr organization: Chungbuk Regional Cardiovascular Center, Chungbuk National University Hospital, Cheongju, Chungcheongbuk-do, Korea – sequence: 2 givenname: Myung-A surname: Kim fullname: Kim, Myung-A email: kma@snu.ac.kr organization: Cardiovascular Center, Seoul National University Boramae Medical Hospital, Seoul, Korea – sequence: 3 givenname: Hack-Lyoung surname: Kim fullname: Kim, Hack-Lyoung email: kma@snu.ac.kr organization: Cardiovascular Center, Seoul National University Boramae Medical Hospital, Seoul, Korea – sequence: 4 givenname: Wan Joo surname: Shim fullname: Shim, Wan Joo email: kma@snu.ac.kr organization: Cardiovascular Center, Korea University Anam Hospital, Seoul, Korea – sequence: 5 givenname: Seong Mi surname: Park fullname: Park, Seong Mi email: kma@snu.ac.kr organization: Cardiovascular Center, Korea University Anam Hospital, Seoul, Korea – sequence: 6 givenname: Mina surname: Kim fullname: Kim, Mina email: kma@snu.ac.kr organization: Cardiovascular Center, Korea University Anam Hospital, Seoul, Korea – sequence: 7 givenname: Hyun Ju surname: Yoon fullname: Yoon, Hyun Ju email: kma@snu.ac.kr organization: Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea – sequence: 8 givenname: Mi Seung surname: Shin fullname: Shin, Mi Seung email: kma@snu.ac.kr organization: Department of Cardiology, Gachon Medical School Gil Medical Center, Incheon, Korea – sequence: 9 givenname: Kyung-Soon surname: Hong fullname: Hong, Kyung-Soon email: kma@snu.ac.kr organization: Department of Cardiology, Hanllym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea – sequence: 10 givenname: Gil Ja surname: Shin fullname: Shin, Gil Ja email: kma@snu.ac.kr organization: Department of Cardiology, Ewha Womans University Hospital, Seoul, Korea – sequence: 11 givenname: Yong-Hyun surname: Kim fullname: Kim, Yong-Hyun email: kma@snu.ac.kr organization: Department of Cardiology, Korea University Guro Hospital, Seoul, Korea – sequence: 12 givenname: Jin Oh surname: Na fullname: Na, Jin Oh email: kma@snu.ac.kr organization: Department of Cardiology, Korea University Guro Hospital, Seoul, Korea – sequence: 13 givenname: Jin-Ok surname: Jeong fullname: Jeong, Jin-Ok email: kma@snu.ac.kr organization: Department of Cardiology, Chungnam National University Hospital, Daejeon, Korea |
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Keywords | diastolic dysfunction left ventricle parity pregnancy |
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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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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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