Key result
Elevated left atrial pressure was associated with higher all-cause mortality compared to normal pressure in patients with dilated cardiomyopathy.
Why the study?
The prognostic significance of left ventricular diastolic dysfunction severity in patients with dilated cardiomyopathy remained uncertain.
Does elevated left atrial pressure and moderate to severe left ventricular diastolic dysfunction worsen prognosis in stable patients with dilated cardiomyopathy?
Observational (n=644)
No
Does elevated left atrial pressure and moderate to severe left ventricular diastolic dysfunction worsen prognosis in stable patients with dilated cardiomyopathy?
Elevated left atrial pressure and moderate to severe left ventricular diastolic dysfunction provide incremental prognostic information over LVEF for mortality in patients with dilated cardiomyopathy.
Answers are grounded in this paper and cite their sources.
May refine mortality risk stratification beyond LVEF in dilated cardiomyopathy; leaves open therapeutic implications pending prospective validation.
AIMS: The prognostic significance of left ventricular (LV) diastolic dysfunction (LVDD) severity in patients with dilated cardiomyopathy (DCM) remains uncertain. This study aimed to evaluate the association of LVDD severity and elevated left atrial pressure (eLAP) with patient outcomes in stable, non-acutely decompensated patients with DCM. METHODS: This single-centre, retrospective, observational study involved 740 DCM patients (either inpatients or outpatients) managed at our tertiary cardiac centre between 2010 and 2021. Due to incomplete data, 96 patients were excluded. LVDD and eLAP were assessed using echocardiography according to the 2016 guidelines of the European Association of Cardiovascular Imaging (EACVI). The primary outcomes were all-cause mortality and heart failure (HF)-related mortality. RESULTS: The final cohort comprised of 644 DCM patients [mean age: 52 ± 12 years, LV ejection fraction (LVEF): 26 ± 10%]. Over a median follow-up period of 41 (18.5-66.7) months, 105 (16.3%) patients died: 8 (5.3%) patients in the normal left atrial pressure (nLAP) group and 97 (19.6%) patients in the eLAP group. eLAP was identified as an independent prognostic factor for both all-cause mortality [hazard ratio (HR) 2.0; 95% confidence interval (CI) 1.1-3.7; P = 0.01] and HF-related mortality (HR 2.5; 95% CI 1.01-6.5; P = 0.04), even after adjusting for LVEF and atrial fibrillation (AF) presence. Additionally, HF-related mortality rates were significantly higher in patients with moderate to severe LVDD compared with those with mild LVDD [5 (3.3%) vs. 67 (13.6%), P < 0.05]. CONCLUSIONS: This study's findings highlight the importance of assessing the severity of LVDD in patients with DCM, which provides incremental prognostic information over LVEF.
No takes yet. Share an insight, caveat, or question.
Winiarczyk et al. (2024) conducted an observational in Dilated cardiomyopathy (n=644). Elevated left atrial pressure (eLAP) vs. Normal left atrial pressure (nLAP) was evaluated on All-cause mortality (HR 2.0, 95% CI 1.1-3.7, p=0.01). Elevated left atrial pressure was associated with higher all-cause mortality compared to normal pressure in patients with dilated cardiomyopathy.
Synapse has enriched 10 related papers. Consider them for comparative context: