Prevalence and prognosis of asymptomatic left ventricular diastolic dysfunction in ambulatory patients with coronary

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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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Xiushui Ren1, Bryan Ristow, Beeya Na

  • 1Department of Cardiology, California Pacific Medical Center, University of California, San Francisco, USA. xiushui@yahoo.com

The American Journal of Cardiology
|June 15, 2007
PubMed

Insights

Asymptomatic moderate to severe left ventricular (LV) diastolic dysfunction in coronary heart disease (CHD) patients predicts heart failure (HF) hospitalization and heart disease death. Aggressive therapy may benefit these patients.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Diagnostic Imaging

Background:

  • Left ventricular (LV) diastolic dysfunction is a known predictor of adverse cardiovascular outcomes.
  • The prevalence and prognostic significance of asymptomatic LV diastolic dysfunction in coronary heart disease (CHD) patients without a history of heart failure (HF) remain unclear.

Purpose of the Study:

  • To investigate the association between asymptomatic LV diastolic dysfunction and cardiovascular outcomes in ambulatory patients with stable CHD and preserved systolic function.

Main Methods:

  • Echocardiography was employed to assess LV diastolic function in 693 patients with stable CHD, normal LV ejection fraction (> or =50%), and no prior HF history.
  • Cox proportional hazards models were utilized to analyze the association of LV diastolic dysfunction with cardiovascular events over a 3-year follow-up period.

Main Results:

  • Moderate to severe LV diastolic dysfunction was identified in 10% of the study cohort (72 out of 693 patients).
  • After multivariable adjustment, moderate to severe LV diastolic dysfunction significantly predicted incident hospitalization for HF (HR 6.3) and death from heart disease (HR 3.9).

Conclusions:

  • Moderate to severe asymptomatic LV diastolic dysfunction is prevalent in patients with stable CHD and normal systolic function.
  • This condition serves as a strong predictor of future HF hospitalizations and cardiac mortality.
  • Patients identified with asymptomatic LV diastolic dysfunction may warrant more intensive therapeutic strategies to prevent or postpone HF development.

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