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Pulsed Wave Doppler Assessment of Diastolic Dysfunction in the ZSF-1 Rat Model of Pulmonary Hypertension Due to Left Heart Disease
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Diastolic dysfunction in heart failure with preserved systolic function: need for objective evidence:results from the

Hans Persson1, Eva Lonn, Magnus Edner

  • 1Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital Department of Cardiology, Stockholm, Sweden. hans.persson@ds.se

Journal of the American College of Cardiology
|February 13, 2007
PubMed

Insights

Diastolic dysfunction (DD) predicts cardiovascular death or heart failure hospitalization in patients with preserved ejection fraction (HF-PSF). Moderate to severe DD indicates a poor prognosis, highlighting the need for its objective assessment in HF-PSF.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Echocardiography

Background:

  • Over 40% of heart failure (HF) hospitalizations involve patients with preserved systolic function (HF-PSF).
  • Diastolic dysfunction (DD) is implicated as a primary cause of HF-PSF clinical manifestations.

Purpose of the Study:

  • To investigate if diastolic dysfunction (DD) is a significant predictor of cardiovascular (CV) death or heart failure (HF) hospitalization.
  • To assess the prognostic value of DD in patients with ejection fraction (EF) >40% within the CHARM-Preserved study.

Main Methods:

  • Doppler echocardiography was used to assess diastolic function, classifying patients into four groups: normal, mild, moderate, and severe DD.
  • Plasma NT-pro-brain natriuretic peptide levels were also utilized for assessment.
  • Patients were followed for a median of 18.7 months after randomization to candesartan or placebo.

Main Results:

  • Diastolic dysfunction (DD) was identified in 67% of patients, with moderate and severe DD present in 44%.
  • Patients with moderate and severe DD experienced significantly poorer outcomes (18% vs. 5%, p < 0.01).
  • Multivariate analysis confirmed moderate (HR 3.7) and severe DD (HR 5.7) as independent predictors of adverse outcomes.

Conclusions:

  • Objective evidence of DD is prevalent in two-thirds of HF-PSF patients.
  • Moderate and severe DD are significant predictors of adverse cardiovascular outcomes in this population.
  • The findings underscore the prognostic importance of objectively diagnosing DD in HF-PSF patients.
Abstract

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