Key result
Left ventricular diastolic dysfunction (Tau > 48 ms and e' < 5.8 cm/s) was independently associated with increased risk for cardiac death or CV hospitalization (25 total events over 1364 days).
Why the study?
Does left ventricular diastolic dysfunction predict cardiac death or cardiovascular hospitalization in patients undergoing cardiac catheterization for CAD?
Cohort (n=222)
Does left ventricular diastolic dysfunction predict cardiac death or cardiovascular hospitalization in patients undergoing cardiac catheterization for CAD?
Impaired left ventricular relaxation, assessed by either invasive catheterization or non-invasive Doppler echocardiography, is an independent predictor of adverse cardiovascular events in patients with CAD.
Diastolic dysfunction may aid prognostication during CAD catheterization; leaves open whether it should guide therapy.
We hypothesized that left ventricular (LV) diastolic dysfunction assessed by cardiac catheterization may be associated with increased risk for cardiovascular events. To test the hypothesis, we assessed diastolic function by cardiac catheterization (relaxation time constant (Tau) and end-diastolic pressure (EDP)) as well as Doppler echocardiography (early diastolic mitral annular velocity (e') and a ratio of early diastolic mitral inflow to annular velocities (E/e')) in 222 consecutive patients undergoing cardiac catheterization for coronary artery disease (CAD). During a followup of 1364 ± 628 days, 5 cardiac deaths and 20 unscheduled cardiovascular hospitalizations were observed. Among LV diastolic function indices, Tau > 48 ms and e' < 5.8 cm/s were each significantly associated with lower rate of survival free of cardiovascular hospitalization. Even after adjustment for potential confounders (traditional cardiovascular risk factors, the severity of CAD, and cardiovascular medications), the predictive value of Tau > 48 ms and e' < 5.8 cm/s remained significant. No predictive value was observed in EDP, E/e', or LV ejection fraction. In conclusion, LV diastolic dysfunction, particularly impaired LV relaxation assessed by both cardiac catheterization and Doppler echocardiography, is independently associated with increased risk for cardiac death or cardiovascular hospitalization in patients with known or suspected CAD.
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Fukuta et al. (2012) conducted a cohort in Coronary Artery Disease (n=222). Left ventricular diastolic dysfunction vs. Normal left ventricular diastolic function was evaluated on Cardiac death or cardiovascular hospitalization. Left ventricular diastolic dysfunction (Tau > 48 ms and e' < 5.8 cm/s) was independently associated with increased risk for cardiac death or CV hospitalization (25 total events over 1364 days).
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