An LV restrictive filling pattern was associated with higher cardiac mortality at 1 year (p<0.001), whereas RV diastolic dysfunction predicted nonfatal hospital admissions (p=0.016).
Cohort (n=105)
Does the presence of left or right ventricular diastolic dysfunction predict mortality and hospital admissions differently in patients with heart failure?
In patients with heart failure, a left ventricular restrictive filling pattern strongly predicts 1-year cardiac mortality, whereas right ventricular diastolic dysfunction predicts nonfatal hospital admissions but not mortality.
p-value: p=<0.001
BACKGROUND: Left (LV) and right (RV) ventricular diastolic dysfunction is common in heart failure but the prognostic value of RV diastolic dysfunction is not known. HYPOTHESIS: As a follow-up to a previously undertaken study, this study was carried out to investigate whether LV and RV diastolic dysfunction affect prognosis differently and, in addition, whether changes in diastolic filling patterns over time correlate with clinical outcome. METHODS: We studied a cohort of 105 patients (mean age 62.7 +/- 1.3 years, 66% male) with heart failure (ejection fraction < 50%) by Doppler echocardiography in both RV and LV. RESULTS: An LV restrictive filling pattern (RFP) was present in 48% of the patients and, when compared with non-RFP subgroups, it was associated with poorer systolic function, higher New York Heart Association functional class, and higher cardiac mortality at 1 year (all p < 0.001). The coexistence of an LV-RFP and poor LV systolic function (ejection fraction < 25%) markedly decreased the 1-year survival that was significant when compared with other subgroups (p = 0.001). In contrast, RV diastolic dysfunction that occurred in 21% of patients was not a prognostic factor for mortality either alone or in combination with LV diastolic dysfunction, but predicted nonfatal hospital admissions for heart failure or unstable angina (p = 0.016). CONCLUSION: An LV restrictive filling pattern is a powerful predictor of a poor prognosis, especially when combined with low ejection fraction, but in this study RV diastolic dysfunction did not appear to be an independent predictor of subsequent mortality.
Yu et al. (Sun,) conducted a cohort in Heart failure (n=105). Left and right ventricular diastolic dysfunction vs. Absence of diastolic dysfunction / non-restrictive filling pattern was evaluated on Cardiac mortality at 1 year (p=<0.001). An LV restrictive filling pattern was associated with higher cardiac mortality at 1 year (p<0.001), whereas RV diastolic dysfunction predicted nonfatal hospital admissions (p=0.016).