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

Hyun Jin Kim, Myung A. Kim, Hack Lyoung Kim, Wan Joo Shim, Seong Mi Park, Mina Kim, Hyun Ju Yoon, Mi Seung Shin, Kyung Soon Hong, Gil Ja Shin, Yong Hyun Kim, Jin Oh Na, Jin Ok Jeong

Research output: Contribution to journalArticle

Abstract

Objectives To investigate the association between left ventricular (LV) diastolic dysfunction and multiparity in patients with suspected coronary artery disease (CAD). Design Cross-sectional study. Setting Linked secondary and tertiary care records from 29 cardiac centres which participated in KoRean wOmen'S chest pain rEgistry. Participants 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. Main outcome measure Prevalence of LV diastolic dysfunction. Results 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 é septal velocities and E/A ratio, and had a significantly higher E/é 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). Conclusions 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.

Original languageEnglish
Article number026968
JournalBMJ Open
Volume8
Issue number12
DOIs
StatePublished - 1 Dec 2018

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Left Ventricular Dysfunction
Parity
Chest Pain
Registries
Cross-Sectional Studies
Coronary Artery Disease
Secondary Care
Ventricular Pressure
Tertiary Healthcare
Coronary Angiography
ROC Curve

Keywords

  • diastolic dysfunction
  • left ventricle
  • parity
  • pregnancy

Cite this

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. / Effects of multiparity on left ventricular diastolic dysfunction in women : Cross-sectional study of the KoRean wOmen'S chest pain rEgistry (KoROSE). In: BMJ Open. 2018 ; Vol. 8, No. 12.
@article{6ce3c97ce29445a2b003e89b6b722e89,
title = "Effects of multiparity on left ventricular diastolic dysfunction in women: Cross-sectional study of the KoRean wOmen'S chest pain rEgistry (KoROSE)",
abstract = "Objectives To investigate the association between left ventricular (LV) diastolic dysfunction and multiparity in patients with suspected coronary artery disease (CAD). Design Cross-sectional study. Setting Linked secondary and tertiary care records from 29 cardiac centres which participated in KoRean wOmen'S chest pain rEgistry. Participants 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. Main outcome measure Prevalence of LV diastolic dysfunction. Results 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). Conclusions 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.",
keywords = "diastolic dysfunction, left ventricle, parity, pregnancy",
author = "Kim, {Hyun Jin} and Kim, {Myung A.} and Kim, {Hack Lyoung} and Shim, {Wan Joo} and Park, {Seong Mi} and Mina Kim and Yoon, {Hyun Ju} and Shin, {Mi Seung} and Hong, {Kyung Soon} and Shin, {Gil Ja} and Kim, {Yong Hyun} and Na, {Jin Oh} and Jeong, {Jin Ok}",
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Effects of multiparity on left ventricular diastolic dysfunction in women : Cross-sectional study of the KoRean wOmen'S chest pain rEgistry (KoROSE). / 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.

In: BMJ Open, Vol. 8, No. 12, 026968, 01.12.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of multiparity on left ventricular diastolic dysfunction in women

T2 - Cross-sectional study of the KoRean wOmen'S chest pain rEgistry (KoROSE)

AU - Kim, Hyun Jin

AU - Kim, Myung A.

AU - Kim, Hack Lyoung

AU - Shim, Wan Joo

AU - Park, Seong Mi

AU - Kim, Mina

AU - Yoon, Hyun Ju

AU - Shin, Mi Seung

AU - Hong, Kyung Soon

AU - Shin, Gil Ja

AU - Kim, Yong Hyun

AU - Na, Jin Oh

AU - Jeong, Jin Ok

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Objectives To investigate the association between left ventricular (LV) diastolic dysfunction and multiparity in patients with suspected coronary artery disease (CAD). Design Cross-sectional study. Setting Linked secondary and tertiary care records from 29 cardiac centres which participated in KoRean wOmen'S chest pain rEgistry. Participants 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. Main outcome measure Prevalence of LV diastolic dysfunction. Results 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 é septal velocities and E/A ratio, and had a significantly higher E/é 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). Conclusions 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.

AB - Objectives To investigate the association between left ventricular (LV) diastolic dysfunction and multiparity in patients with suspected coronary artery disease (CAD). Design Cross-sectional study. Setting Linked secondary and tertiary care records from 29 cardiac centres which participated in KoRean wOmen'S chest pain rEgistry. Participants 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. Main outcome measure Prevalence of LV diastolic dysfunction. Results 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 é septal velocities and E/A ratio, and had a significantly higher E/é 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). Conclusions 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.

KW - diastolic dysfunction

KW - left ventricle

KW - parity

KW - pregnancy

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U2 - 10.1136/bmjopen-2018-026968

DO - 10.1136/bmjopen-2018-026968

M3 - Article

C2 - 30593559

AN - SCOPUS:85059238387

VL - 8

JO - BMJ open

JF - BMJ open

SN - 2044-6055

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