Opportunistic screening models for high-risk men and women to detect diastolic dysfunction and heart failure with preserved ejection fraction in the community

作者：Aisha Gohar, Rogier F Kievit, Gideon Valstar, Arno W. Hoes, Evelien ES van Riet, Yvonne van Mourik, Loes C.M. Bertens, Leandra J Boonman-Winter, Michiel L. Bots, Hester M. den Ruijter, Frans H. Rutten · 发表于：European Journal of Preventive Cardiology · 年份：2018 · DOI：10.1177/2047487318816774 · 被引用次数：24 · 研究领域：Cardiovascular Function and Risk Factors、Heart Failure Treatment and Management、Blood Pressure and Hypertension Studies

BACKGROUND: The prevalence of undetected left ventricular diastolic dysfunction is high, especially in the elderly with comorbidities. Left ventricular diastolic dysfunction is a prognostic indicator of heart failure, in particularly of heart failure with preserved ejection fraction and of future cardiovascular and all-cause mortality. Therefore we aimed to develop sex-specific diagnostic models to enable the early identification of men and women at high-risk of left ventricular diastolic dysfunction with or without symptoms of heart failure who require more aggressive preventative strategies. DESIGN: Individual patient data from four primary care heart failure-screening studies were analysed (1371 participants, excluding patients classified as heart failure and left ventricular ejection fraction <50%). METHODS: Eleven candidate predictors were entered into logistic regression models to be associated with the presence of left ventricular diastolic dysfunction/heart failure with preserved ejection fraction in men and women separately. Internal-external cross-validation was performed to develop and validate the models. RESULTS: Increased age and β-blocker therapy remained as predictors in both the models for men and women. The model for men additionally consisted of increased body mass index, moderate to severe shortness of breath, increased pulse pressure and history of ischaemic heart disease. The models performed moderately and similarly well in men (c-statistics range 0.60-...