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November 4, 2024ESC Heart FailureOpen Access

Elevated left atrial pressure was associated with higher all-cause mortality compared to normal pressure in patients with dilated cardiomyopathy (19.6% vs 5.3%; HR 2.0; 95% CI 1.1-3.7; P=0.01).

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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?

Population

644 stable, non-acutely decompensated patients with DCM

Comparison

LVDD severity and elevated left atrial pressure vs normal left atrial pressure

Design

Single-centre retrospective observational study

Follow-up

Median 41 (18.5-66.7) months

Key result

Elevated left atrial pressure was associated with higher all-cause mortality compared to normal pressure in patients with dilated cardiomyopathy (19.6% vs 5.3%; HR 2.0; 95% CI 1.1-3.7; P=0.01).

Authors

MWMateusz WiniarczykEDEwa DziewięckaSWSylwia Wiśniowska‐Śmiałek

Discussion

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Overview

May refine mortality risk stratification beyond LVEF in dilated cardiomyopathy; leaves open therapeutic implications pending prospective validation.

Study Design

Type

Observational (n=644)

Multicenter

No

Structured PICO

Does elevated left atrial pressure and moderate to severe left ventricular diastolic dysfunction worsen prognosis in stable patients with dilated cardiomyopathy?

P
Population
644 stable, non-acutely decompensated patients with dilated cardiomyopathy (mean age 52 years, mean LVEF 26%) followed for a median of 41 months.
E
Exposure
Elevated left atrial pressure (eLAP) and moderate to severe left ventricular diastolic dysfunction (LVDD) assessed by echocardiography
C
Comparator
Normal left atrial pressure (nLAP) and mild LVDD
O
Outcome
All-cause mortality and heart failure (HF)-related mortality at median 41 months follow-uphard clinical

Main Result

Hazard Ratio: 2 (95% CI 1.1–3.7)

Absolute Event Rate: 19.6% vs 5.3%

p-value: p=0.01

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.

Cite This Study

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 (19.6% vs 5.3%; HR 2.0; 95% CI 1.1-3.7; P=0.01).

synapsesocial.com/papers/6a95b3286360535a90ebf005https://doi.org/10.1002/ehf2.15119
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Relation between cardiac magnetic resonance-assessed interstitial fibrosis and diastolic dysfunction in heart failure due to dilated cardiomyopathy2024 · 1 citations
  2. 2Assessment of the Left Ventricular Diastolic Function and Its Association with the Left Atrial Pressure in Patients with Atrial Fibrillation2020 · 11 citations
  3. 33D ventricular stiffness versus systolic dysfunction: rethinking outcome predictors in dilated cardiomyopathy2026
  4. 4Prevalence and prognosis of left ventricular diastolic dysfunction in community hypertension patients2022 · 19 citations
  5. 5The Impact of Left Ventricular Diastolic Dysfunction for the Prognosis in Patients with Lower Extremity Arterial Disease2020 · 1 citations