Key result
Advanced left ventricular diastolic dysfunction (grade II/III) was independently associated with a higher risk of 1-year all-cause mortality compared to grade 0/I dysfunction (19% vs. 10.2%; HR 1.72).
Why the study?
The study was conducted to assess the prevalence of advanced left ventricular diastolic dysfunction in consecutive patients referred for echocardiography and its association with mortality.
Does advanced left ventricular diastolic dysfunction (grade II/III) predict 1-year all-cause mortality in patients with normal or preserved LV systolic function?
Cohort (n=4,481)
No
Does advanced left ventricular diastolic dysfunction (grade II/III) predict 1-year all-cause mortality in patients with normal or preserved LV systolic function?
Advanced left ventricular diastolic dysfunction (grade II/III) is a strong independent predictor of 1-year all-cause mortality in patients with preserved LV systolic function.
Answers are grounded in this paper and cite their sources.
Advanced LVDD may aid short-term risk stratification in preserved-EF patients; leaves open prospective trials to test management impact.
Aim: To assess the prevalence of advanced left ventricular diastolic dysfunction (LVDD) in a cohort of consecutive patients referred for echocardiography and its association with mortality. Methods: The cohort included 4,481 (85% hospitalized) patients who underwent echocardiography, had normal or preserved LV systolic function and diastolic function assessment. LVDD was graded as none or mild (0/I) and advanced grade (II/III). Mortality data were derived from the National Israeli Population Registry. Results: LVDD grade II/III was found in 1,262 patients (28%), was more prevalent among the elderly, females, diabetic and hypertensive patients. Independent predictors associated with LVDD grade II/III (OR; 95% CI) were: age (1-year increment) 1.015 (1.01-1.02), p<0.001; female sex 1.2 (1.04-1.39), p=0.012; hypertension 1.53 (1.30-1.80), p<0.001, while ischaemic heart disease was negatively associated 0.73 (0.63- 0.85), p<0.001. 1-year mortality rates were higher among grade II/III LVDD as compared to grade 0/I DD patients, 19% vs. 10.2%, respectively, p<0.0001. Independent predictors for all-cause mortality after adjusting for pertinent variables were: LVDD grade II/III 1.72 (1.40-2.11); age (1-year increment) 1.08 (1.07-1.09) and diabetes 1.54 (1.26-1.70), p<0.001 for all. Conclusion: LVDD grade II/III was more prevalent among the elderly, females, diabetic and hypertensive patients. Advanced LVDD was a strong independent predictor for all-cause mortality after adjustment for risk factors. Intensive pharmacological therapies at an earlier stage of LVDD may improve patients’ outcome.
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Moriel et al. (2021) conducted a cohort in Normal or preserved left ventricular systolic function (n=4,481). Advanced Left Ventricular Diastolic Dysfunction (LVDD grade II/III) vs. LVDD grade 0/I was evaluated on 1-year all-cause mortality (HR 1.72, 95% CI 1.40-2.11, p=<0.001). Advanced left ventricular diastolic dysfunction (grade II/III) was independently associated with a higher risk of 1-year all-cause mortality compared to grade 0/I dysfunction (19% vs. 10.2%; HR 1.72).
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