Key result
Grade II-III diastolic dysfunction is linked to ~49% higher mortality in at least moderate AR.
Why the study?
The study aimed to investigate the relationship between diastolic dysfunction and extracellular volume, scar burden, and myocyte volume by CMR, as well as its association with mortality in patients with at least moderate aortic regurgitation.
Is diastolic dysfunction associated with adverse myocardial remodeling and increased mortality in patients with at least moderate aortic regurgitation?
Cohort (n=323)
Is diastolic dysfunction associated with adverse myocardial remodeling and increased mortality in patients with at least moderate aortic regurgitation?
Hazard Ratio: 1.49 (95% CI 1.1–1.98)
p-value: p=0.009
In patients with at least moderate aortic regurgitation, advanced diastolic dysfunction is associated with adverse myocardial remodeling on CMR and independently predicts increased mortality.
AIMS: This study aimed to investigate the relationship between diastolic dysfunction (DD) and extracellular volume (ECV), scar burden, and myocyte volume in patients with at least moderate aortic regurgitation (AR) by cardiac magnetic resonance (CMR). We also sought to determine the association of DD with mortality in AR patients. METHODS AND RESULTS: Patients with at least moderate AR and who underwent echocardiographic and CMR imaging with a median time of 4 days between the two studies (interquartile range 1-43 days) were included. CMR was used to obtain left ventricular (LV) volumes, ejection fraction and mass, AR severity, scar extent, and ECV. DD was assessed by comprehensive echocardiography. The study included 323 patients. The mean age was 61.9 ± 16.0 and the median follow-up was 3.8 years, during which 86 patients died and 69 were hospitalized for heart failure. LV end-systolic volume, LV mass index, ECV, indexed cellular volume, and scar burden increased with advanced DD (P < 0.01). In multivariable Cox proportional hazard models, Grades II and III DD were independently associated with increased mortality (HR = 1.49, 95% CI = 1.1-1.98, P = 0.009). CONCLUSION: ECV, scar, and myocyte volume by CMR progressively increase with higher grades of DD by echocardiography, and DD is independently associated with mortality in patients with at least moderate AR.
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Lababidi et al. (2025) conducted a cohort in Aortic regurgitation (n=323). Diastolic dysfunction vs. Lower grades of diastolic dysfunction was evaluated on Mortality (HR 1.49, 95% CI 1.1-1.98, p=0.009). Grades II and III diastolic dysfunction were independently associated with increased mortality in patients with at least moderate aortic regurgitation (HR 1.49; 95% CI 1.1-1.98; P=0.009).
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