Key result
Among patients with HFrEF and HFmrEF, the presence of ≥2 non-cardiac comorbidities was associated with more impaired proto-diastolic relaxation (mean τ 62 vs 48 ms; P<0.001).
Why the study?
The impact of non-cardiac comorbidities on left ventricular diastolic properties in HFrEF and HFmrEF patients remains uncertain.
Does the presence of multiple non-cardiac comorbidities impair left ventricular diastolic properties in patients with HFrEF and HFmrEF?
Observational (n=75)
Does the presence of multiple non-cardiac comorbidities impair left ventricular diastolic properties in patients with HFrEF and HFmrEF?
Absolute Event Rate: 62% vs 48%
p-value: p=<0.001
In patients with HFrEF and HFmrEF, the presence of multiple non-cardiac comorbidities is associated with impaired proto-diastolic relaxation but not increased diastolic stiffness.
Comorbidities may influence diastolic properties in HFrEF/HFmrEF; leaves open causal links and management implications.
Background and purpose The impact of non-cardiac comorbidities on left ventricular (LV) diastolic properties in HFrEF and HFmrEF patients is still uncertain. Aim of the study was to determine how comorbidities affect LV relaxation and diastolic compliance in patients with HFrEF and HFmrEF. Methods Consecutive patients diagnosed with HFrEF or HFmrEF were enrolled. Non-cardiac comorbidity were recorded: diabetes, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), obstructive sleep apnea syndrome (OSAS), dyslipidemia and active or previous cancer. Patients underwent laboratory tests, including NT-pro-BNP. The following diastolic properties were evaluated non-invasively by echocardiography using previously validated methods: the time constant of isovolumetric relaxation (τ) and the diastolic stiffness index (β). Left atrial volume index (LAVi) was also recorded. Patients were divided in two groups: a) ≥2 comorbidities and b) <2 comorbidities. Results Seventy-five patients were enrolled of whom 73% reported dyslipidaemia, 26% diabetes, 20% CKD, 18% COPD, 8% cancer, 4% OSAS. Thirty-five patients (47%) presented with ≥2 comorbidities showing higher values of τ (62±15ms vs 48±15ms, p<0.001). Non- significant differences were found in β (6.12±0.3 vs 6.17±0.2; p= 0.582), left atrial volume index (47±34 vs 40±19, p= 0.386) and log-transformed NT-pro-BNP (6.2±1.4 vs 5.6±1.3; p= 0.323). Conclusion Among patients with HFrEF e HFmrEF the presence of multiple non-cardiac comorbidities was associated with more impaired proto-diastolic relaxation reflected by higher τ values. No significant differences were found in diastolic stiffness (β) and imaging and laboratory characteristics suggestive of increased end-diastolic LV filling pressure.
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Serino et al. (2022) conducted an observational in HFrEF and HFmrEF (n=75). ≥2 non-cardiac comorbidities vs. <2 non-cardiac comorbidities was evaluated on time constant of isovolumetric relaxation (τ) (p=<0.001). Among patients with HFrEF and HFmrEF, the presence of ≥2 non-cardiac comorbidities was associated with more impaired proto-diastolic relaxation (mean τ 62 vs 48 ms; P<0.001).
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