A higher left ventricular diastolic dysfunction score was independently associated with an increased risk of cardiovascular death, heart failure hospitalization, or mitral valve surgery (HR 1.39).
Observational (n=173)
No
Does left ventricular diastolic dysfunction predict adverse clinical outcomes in patients with primary mitral regurgitation?
In patients with primary mitral regurgitation, echocardiographic assessment of left ventricular diastolic dysfunction provides incremental prognostic value for adverse clinical outcomes beyond clinical characteristics and MR severity.
Hazard Ratio: 1.39 (95% CI 1.14–1.69)
p-value: p=0.001
Patients with significant primary mitral regurgitation (MR) can develop left ventricular (LV) diastolic dysfunction (DD). We sought to study LV structural correlates, and prognostic significance of DD. Patients with ≥ moderate primary MR with echocardiographic and CMR scans within a median time of 5 days were included. LV volumes, EF, MR volume and fraction, presence of scar, and extracellular volume (ECV) were assessed by CMR. LV diastolic function (DF) was assessed by echocardiography using time delay between onset of mitral E velocity and mitral annulus e' velocity, deceleration time of mitral E velocity, and duration difference between pulmonary vein atrial velocity and mitral A velocity. DF score was computed based on these 3 variables. Event rate (heart failure hospitalizations, cardiovascular death, or mitral valve surgery) was higher in patients with DD versus patients with normal DF (P < 0.05). MR volumes, and ECV were significantly higher in patients with DD (P < 0.001). In multivariable cox proportional hazard model, inclusion of DF score increased AUC from 0.83 to 0.86. Thus, DD is associated with ECV, MR severity, and clinical outcomes. DD score provides incremental value for the prediction of adverse outcomes when added to clinical characteristics, MR severity, and LV end diastolic volume index.
Lababidi et al. (Wed,) conducted a observational in Primary mitral regurgitation (n=173). Left ventricular diastolic dysfunction score vs. Normal diastolic function was evaluated on Composite of first occurrence of heart failure hospitalization, cardiovascular death, or mitral valve surgery (HR 1.39, 95% CI 1.14-1.69, p=0.001). A higher left ventricular diastolic dysfunction score was independently associated with an increased risk of cardiovascular death, heart failure hospitalization, or mitral valve surgery (HR 1.39).