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Increased mortality in patients with conflicting diastolic parameters
Samira Bahrainy1, Michelle Vo, Edward A Gill
1Division of Cardiology, University of Washington, Harborview Medical Center, Seattle, WA 98104, USA. samira11@uw.edu
The International Journal of Cardiovascular Imaging
|June 1, 2011
Summary
Conflicting diastolic function, often unclassifiable by echocardiography, is linked to higher mortality risk. This highlights the need for better categorization of diastolic dysfunction in patients.
Area of Science:
- Cardiology
- Echocardiography
- Diastology
Background:
- Up to 30% of patients exhibit conflicting diastolic function, preventing clear classification into stages 1, 2, or 3 using standard echo Doppler.
- This ambiguity poses challenges in risk stratification and management of heart failure with preserved ejection fraction (HFpEF).
Purpose of the Study:
- To investigate the clinical characteristics and mortality associated with conflicting diastolic function.
- To compare outcomes of patients with conflicting diastolic function against those with normal diastolic parameters.
Main Methods:
- A cohort of 250 subjects with conflicting diastolic function was identified from an echocardiography database.
- Each subject was compared to two controls with normal diastolic and systolic function.
- A 6-year follow-up was conducted using Cox proportional hazards models to assess mortality risk.
Main Results:
- Patients with conflicting diastolic function had higher prevalence of diabetes, hypertension, and coronary artery disease.
- The unadjusted Cox model showed a significantly higher risk of death (HR: 1.83; 95% CI: 1.32-2.53; P < 0.001).
- After adjusting for covariates, the elevated risk of death persisted (HR: 1.56; 95% CI: 1.11-2.18; P = 0.009).
Conclusions:
- Conflicting diastolic dysfunction is independently associated with an increased risk of mortality.
- These findings underscore the clinical significance of unclassified diastolic dysfunction.
- There is a critical need for improved methods to characterize and categorize patients with diastolic dysfunction for better patient outcomes.
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