Racial Differences of Cardiac Structure and Function in Heart Failure With Preserved Ejection Fraction

HIDEMI SORIMACHI, MASARU OBOKATA, KAZUNORI OMOTE, YOGESH N.V. REDDY, DANIEL BURKHOFF, SANJIV J. SHAH, BARRY A. BORLAUG*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Potential race differences in cardiac structure and function among patients with heart failure with preserved ejection fraction (HFpEF) are not well-understood, but may have pathophysiological and treatment implications. Methods and Results: In this study, patients with HFpEF who self-identified as Asian (n = 360), White (n = 787), and Black (n = 171) from 3 institutions underwent comprehensive transthoracic echocardiography to evaluate for potential differences. The Asian HFpEF group was oldest and the Black HFpEF group was youngest (75 ± 12 years vs 73 ± 13 years vs 62 ± 12 years; P < .0001). Women constituted the lowest proportion of patients with HFpEF among Asian individuals, but were the largest among Black patients (49% vs 56% vs 73%; P < .0001). Body mass index and obesity prevalence were highest in Black patients with HFpEF and were lowest in Asian patients. Black individuals with HFpEF had greater left ventricular (LV) wall thickening and concentricity, smaller LV chamber size, leftward-shifted LV end-diastolic pressure–volume relationship, indicating greater LV stiffening, smallest left atrial volumes, and the most right ventricular dilatation. Asian individuals with HFpEF had greater LV and left atrial dilation, more rightward shifted LV end-diastolic pressure–volume relationship, and the highest arterial stiffness. Conclusions: In summary, we show that patients with HFpEF of Asian, Black, and White race display key differences in clinical, anthropometric, and cardiac structure-function indices, indicating that consideration of race-related differences might important to individualize treatment strategies in HFpEF.

Original languageEnglish (US)
JournalJournal of Cardiac Failure
DOIs
StateAccepted/In press - 2024

Funding

Supported in part by NIH grants R01 HL128526, R01 HL162828, and U01 HL160226 and by the US Department of Defense: W81XWH2210245 (to Dr. Borlaug). Dr. Shah was supported by research grants from the National Institutes of Health (U54 HL160273, R01 HL107577, R01 HL127028, R01 HL140731, and R01 HL149423).

Keywords

  • cardiac structure
  • diastolic function
  • heart failure
  • HFpEF
  • Race

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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