Table 1_Sublingual microcirculation-derived glycocalyx barrier impairment independently predicts progression of asymptomatic left ventricular diastolic dysfunction in elderly Chinese adults.doc

EG integrity was assessed at baseline using sidestream dark field imaging-derived perfused boundary region (PBR) of the sublingual microcirculation, with a higher PBR indicating greater glycocalyx barrier impairment. Diastolic function was evaluated by echocardiography according to the 2016 ASE/EACVI criteria at baseline and after a median follow-up of 23 months. Multivariable logistic regression and linear mixed-effects models were used to evaluate cross-sectional and longitudinal associations.</p>Results<p>The prevalence of ALVDD at baseline was 9.74% (n = 49).

PBR was significantly higher in participants with ALVDD than in those with normal diastolic function (2.43 vs. 1.84 μm, P < 0.01). After adjustment for the HOMAGE score, each 0.1 μm increase in PBR was independently associated with a 12% higher odds of ALVDD (OR 1.12, 95% CI 1.06-1.18, P < 0.01). Adding PBR to the HOMAGE score significantly improved discriminative ability (AUC from 0.656 to 0.712, P = 0.04; NRI 0.73, P = 0.02).

During follow up, participants with higher baseline PBR showed significantly greater annual deteriorations in E/e’ ratio and septal/lateral e' velocities compared with those with lower PBR (all P for trend <0.01).</p>Conclusions<p>Greater EG barrier impairment, non-invasively quantified by sublingual PBR, is independently associated with both the presence and longitudinal progression of ALVDD in an elderly Chinese population.

PBR may serve as a useful marker for early detection of diastolic deterioration and and raises the hypothesis that PBR could serve as a potential target for preventive interventions, which requires prospective validation.</p>