Diastolic dysfunction in primary care: medical and nursing interlocutions.
Adson Renato Leite, Aretha Pereira de Oliveira, Dalmo Valério Machado de Lima and 2 others
PMID 41370457WHAT IT FOUND
In primary-care adults, E/A ratio abnormality was not linked to cardiovascular hospitalization or death once age and sex were considered, although 84.9% of participants had E/A alterations without a formal heart failure diagnosis.
Key findings
01After adjustment for age and sex, the E/A ratio was not significantly associated with the composite outcome.
02In crude analysis, the E/A ratio was significantly associated with the composite outcome at both cut-offs.
0384.9% of participants had E/A alterations despite not having a formal diagnosis of heart failure.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The adjusted analysis did not find a significant association, and the authors suggested the sample may have been underpowered. 73 of 633 participants were lost to follow-up (11.5%), so the analysed group may not represent all baseline participants. Echocardiography used four portable devices from different manufacturers, and recordings could not be stored, so intra- and inter-examiner variability was not calculated. The sample was community-based adults aged 45 to 99 years enrolled in a Family Doctor Program in Niterói, Brazil, so generalisability may be limited. The outcome combined cardiovascular hospitalization and death from any cause, so it cannot separate which component drove events.
Declared interests
The study was supported by the Research Support Program (Fopesq/UFF) and CNPq.
The easy way to misread this
Do not read the significant crude E/A associations as proof that the ratio independently predicts cardiovascular hospitalization or death. After adjustment for age and sex, those associations were not statistically significant.