Higher number of live births is associated with left ventricular diastolic dysfunction and adverse cardiac remodelling among US Hispanic/Latina women: Results from the Echocardiographic Study of Latinos

Shivani R. Aggarwal, David M. Herrington, Catherine J. Vladutiu, Jill C. Newman, Katrina Swett, Franklyn Gonzalez, Jorge R. Kizer, Michelle A. Kominiarek, Karen M. Tabb, Linda C. Gallo, Gregory A. Talavera, Barry E. Hurwitz, Carlos J. Rodriguez

Research output: Contribution to journalArticle

Abstract

Introduction: Female sex is a risk factor for heart failure with preserved ejection fraction (HFpEF). Previous literature suggests that some diastolic dysfunction (DD) develops during pregnancy and may persist postdelivery. Our objective was to examine the relationship between parity and cardiac structure and function in a population-based cohort. Methods: Participants included 1172 Hispanic/Latina women, aged ≥45 years, enrolled in the Echocardiographic Study of Latinos from four US communities (Bronx, Miami, San Diego and Chicago). Standard echocardiographic techniques were used to measure cardiac volumes, left ventricular mass, systolic and diastolic function. Using sampling weights and survey statistics, multivariable linear and logistic regression models were constructed adjusting for age, body mass index, diabetes or prediabetes, systolic blood pressure, use of antihypertensive medications, smoking, total cholesterol and high-density lipoprotein cholesterol. Results: In the target population, 5.0% were nulliparous (no live births) and 10.5% were grand multiparous (≥5 live births). Among the nulliparous women, 46% had DD as compared with 51%-58% of women with 1-4 live births and 81% of women with ≥5 live births (p<0.01). In full multivariate models, higher parity was significantly associated with greater left ventricular end-systolic volumes, end-diastolic volumes, left atrial volume indices and presence of DD (all p<0.01) but was not associated with ejection fraction. The log odds for having any grade of DD in grand-multiparous women was over three times that seen in nulliparous women (OR=3.4, 95% CI 1.5 to 7.9, p<0.01) in models further adjusted for income and education. Conclusions: Higher parity is associated with increased cardiac mass, volumes and the presence of DD. Further studies are needed to elucidate this apparent deleterious relation and whether parity can help explain the increased risk of HFpEF in women.

Original languageEnglish (US)
JournalOpen Heart
Volume4
Issue number1
DOIs
StatePublished - May 1 2017

Fingerprint

Live Birth
Left Ventricular Dysfunction
Hispanic Americans
Parity
Cardiac Volume
Heart Failure
Logistic Models
Blood Pressure
Prediabetic State
Health Services Needs and Demand
Stroke Volume
HDL Cholesterol
Antihypertensive Agents
Linear Models
Body Mass Index
Smoking
Cholesterol
Education
Weights and Measures
Pregnancy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Higher number of live births is associated with left ventricular diastolic dysfunction and adverse cardiac remodelling among US Hispanic/Latina women : Results from the Echocardiographic Study of Latinos. / Aggarwal, Shivani R.; Herrington, David M.; Vladutiu, Catherine J.; Newman, Jill C.; Swett, Katrina; Gonzalez, Franklyn; Kizer, Jorge R.; Kominiarek, Michelle A.; Tabb, Karen M.; Gallo, Linda C.; Talavera, Gregory A.; Hurwitz, Barry E.; Rodriguez, Carlos J.

In: Open Heart, Vol. 4, No. 1, 01.05.2017.

Research output: Contribution to journalArticle

Aggarwal, SR, Herrington, DM, Vladutiu, CJ, Newman, JC, Swett, K, Gonzalez, F, Kizer, JR, Kominiarek, MA, Tabb, KM, Gallo, LC, Talavera, GA, Hurwitz, BE & Rodriguez, CJ 2017, 'Higher number of live births is associated with left ventricular diastolic dysfunction and adverse cardiac remodelling among US Hispanic/Latina women: Results from the Echocardiographic Study of Latinos', Open Heart, vol. 4, no. 1. https://doi.org/10.1136/openhrt-2016-000530
Aggarwal, Shivani R. ; Herrington, David M. ; Vladutiu, Catherine J. ; Newman, Jill C. ; Swett, Katrina ; Gonzalez, Franklyn ; Kizer, Jorge R. ; Kominiarek, Michelle A. ; Tabb, Karen M. ; Gallo, Linda C. ; Talavera, Gregory A. ; Hurwitz, Barry E. ; Rodriguez, Carlos J. / Higher number of live births is associated with left ventricular diastolic dysfunction and adverse cardiac remodelling among US Hispanic/Latina women : Results from the Echocardiographic Study of Latinos. In: Open Heart. 2017 ; Vol. 4, No. 1.
@article{aa3141a516474172a7862b4e56f98c59,
title = "Higher number of live births is associated with left ventricular diastolic dysfunction and adverse cardiac remodelling among US Hispanic/Latina women: Results from the Echocardiographic Study of Latinos",
abstract = "Introduction: Female sex is a risk factor for heart failure with preserved ejection fraction (HFpEF). Previous literature suggests that some diastolic dysfunction (DD) develops during pregnancy and may persist postdelivery. Our objective was to examine the relationship between parity and cardiac structure and function in a population-based cohort. Methods: Participants included 1172 Hispanic/Latina women, aged ≥45 years, enrolled in the Echocardiographic Study of Latinos from four US communities (Bronx, Miami, San Diego and Chicago). Standard echocardiographic techniques were used to measure cardiac volumes, left ventricular mass, systolic and diastolic function. Using sampling weights and survey statistics, multivariable linear and logistic regression models were constructed adjusting for age, body mass index, diabetes or prediabetes, systolic blood pressure, use of antihypertensive medications, smoking, total cholesterol and high-density lipoprotein cholesterol. Results: In the target population, 5.0{\%} were nulliparous (no live births) and 10.5{\%} were grand multiparous (≥5 live births). Among the nulliparous women, 46{\%} had DD as compared with 51{\%}-58{\%} of women with 1-4 live births and 81{\%} of women with ≥5 live births (p<0.01). In full multivariate models, higher parity was significantly associated with greater left ventricular end-systolic volumes, end-diastolic volumes, left atrial volume indices and presence of DD (all p<0.01) but was not associated with ejection fraction. The log odds for having any grade of DD in grand-multiparous women was over three times that seen in nulliparous women (OR=3.4, 95{\%} CI 1.5 to 7.9, p<0.01) in models further adjusted for income and education. Conclusions: Higher parity is associated with increased cardiac mass, volumes and the presence of DD. Further studies are needed to elucidate this apparent deleterious relation and whether parity can help explain the increased risk of HFpEF in women.",
author = "Aggarwal, {Shivani R.} and Herrington, {David M.} and Vladutiu, {Catherine J.} and Newman, {Jill C.} and Katrina Swett and Franklyn Gonzalez and Kizer, {Jorge R.} and Kominiarek, {Michelle A.} and Tabb, {Karen M.} and Gallo, {Linda C.} and Talavera, {Gregory A.} and Hurwitz, {Barry E.} and Rodriguez, {Carlos J.}",
year = "2017",
month = "5",
day = "1",
doi = "10.1136/openhrt-2016-000530",
language = "English (US)",
volume = "4",
journal = "Open Heart",
issn = "2053-3624",
publisher = "BMJ Publishing Group",
number = "1",

}

TY - JOUR

T1 - Higher number of live births is associated with left ventricular diastolic dysfunction and adverse cardiac remodelling among US Hispanic/Latina women

T2 - Results from the Echocardiographic Study of Latinos

AU - Aggarwal, Shivani R.

AU - Herrington, David M.

AU - Vladutiu, Catherine J.

AU - Newman, Jill C.

AU - Swett, Katrina

AU - Gonzalez, Franklyn

AU - Kizer, Jorge R.

AU - Kominiarek, Michelle A.

AU - Tabb, Karen M.

AU - Gallo, Linda C.

AU - Talavera, Gregory A.

AU - Hurwitz, Barry E.

AU - Rodriguez, Carlos J.

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Introduction: Female sex is a risk factor for heart failure with preserved ejection fraction (HFpEF). Previous literature suggests that some diastolic dysfunction (DD) develops during pregnancy and may persist postdelivery. Our objective was to examine the relationship between parity and cardiac structure and function in a population-based cohort. Methods: Participants included 1172 Hispanic/Latina women, aged ≥45 years, enrolled in the Echocardiographic Study of Latinos from four US communities (Bronx, Miami, San Diego and Chicago). Standard echocardiographic techniques were used to measure cardiac volumes, left ventricular mass, systolic and diastolic function. Using sampling weights and survey statistics, multivariable linear and logistic regression models were constructed adjusting for age, body mass index, diabetes or prediabetes, systolic blood pressure, use of antihypertensive medications, smoking, total cholesterol and high-density lipoprotein cholesterol. Results: In the target population, 5.0% were nulliparous (no live births) and 10.5% were grand multiparous (≥5 live births). Among the nulliparous women, 46% had DD as compared with 51%-58% of women with 1-4 live births and 81% of women with ≥5 live births (p<0.01). In full multivariate models, higher parity was significantly associated with greater left ventricular end-systolic volumes, end-diastolic volumes, left atrial volume indices and presence of DD (all p<0.01) but was not associated with ejection fraction. The log odds for having any grade of DD in grand-multiparous women was over three times that seen in nulliparous women (OR=3.4, 95% CI 1.5 to 7.9, p<0.01) in models further adjusted for income and education. Conclusions: Higher parity is associated with increased cardiac mass, volumes and the presence of DD. Further studies are needed to elucidate this apparent deleterious relation and whether parity can help explain the increased risk of HFpEF in women.

AB - Introduction: Female sex is a risk factor for heart failure with preserved ejection fraction (HFpEF). Previous literature suggests that some diastolic dysfunction (DD) develops during pregnancy and may persist postdelivery. Our objective was to examine the relationship between parity and cardiac structure and function in a population-based cohort. Methods: Participants included 1172 Hispanic/Latina women, aged ≥45 years, enrolled in the Echocardiographic Study of Latinos from four US communities (Bronx, Miami, San Diego and Chicago). Standard echocardiographic techniques were used to measure cardiac volumes, left ventricular mass, systolic and diastolic function. Using sampling weights and survey statistics, multivariable linear and logistic regression models were constructed adjusting for age, body mass index, diabetes or prediabetes, systolic blood pressure, use of antihypertensive medications, smoking, total cholesterol and high-density lipoprotein cholesterol. Results: In the target population, 5.0% were nulliparous (no live births) and 10.5% were grand multiparous (≥5 live births). Among the nulliparous women, 46% had DD as compared with 51%-58% of women with 1-4 live births and 81% of women with ≥5 live births (p<0.01). In full multivariate models, higher parity was significantly associated with greater left ventricular end-systolic volumes, end-diastolic volumes, left atrial volume indices and presence of DD (all p<0.01) but was not associated with ejection fraction. The log odds for having any grade of DD in grand-multiparous women was over three times that seen in nulliparous women (OR=3.4, 95% CI 1.5 to 7.9, p<0.01) in models further adjusted for income and education. Conclusions: Higher parity is associated with increased cardiac mass, volumes and the presence of DD. Further studies are needed to elucidate this apparent deleterious relation and whether parity can help explain the increased risk of HFpEF in women.

UR - http://www.scopus.com/inward/record.url?scp=85019130184&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85019130184&partnerID=8YFLogxK

U2 - 10.1136/openhrt-2016-000530

DO - 10.1136/openhrt-2016-000530

M3 - Article

AN - SCOPUS:85019130184

VL - 4

JO - Open Heart

JF - Open Heart

SN - 2053-3624

IS - 1

ER -