Race-related differences among patients with left ventricular dysfunction:Observations from a biracial angiographic cohort

Background: This study was designed to describe race-related differences in left ventricular function among a consecutive series of patients undergoin g cardiac catheterization and to identify racial differences in coexistent medical and social conditions that are associated with the development of h eart failure (HF). Methods and Results: This was a prospective cohort study conducted at 2 uni versity-affiliated teaching hospitals. We used the database of the Harlem-B assett Lp(a) Study. We included all black (N = 143) or white (N = 313) pati ents from the main study database for whom complete survey. laboratory, cor onary angiographic, and ventriculographic data were available. "Left ventri cular dysfunction" was arbitrarily defined as an ejection fraction less tha n or equal to 0.40 or prior pharmacologic treatment for HF. We found that b lacks were younger, had a higher proportion of women, and had fewer years o f formal education than their white counterparts. Coronary artery disease w as less common among blacks, although this group had a higher prevalence of hypertension, diabetes, cigarette smoking, illicit drug use, and alcohol c onsumption. Black patients had a higher prevalence of previous treatment fo r HF, larger left ventricular volumes, and lower ejection fractions than wh ite patients. Blacks with left ventricular dysfunction were more likely to have had a previous myocardial infarction or a history of hypertension comp ared with those without left ventricular dysfunction. Conclusions: Regarding left ventricular dysfunction and HF, we conclude tha t blacks seem to have a much higher burden of disease than whites. Our obse rvations support prior evidence that hypertension is linked to race-related differences in the epidemiology of HF. The interaction between race and ac cess to quality carl for HF remains an important area for future investigat ion.