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Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism
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Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism

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Mortality rate in patients with diastolic dysfunction and normal systolic function

Carmel M Halley1, Penny L Houghtaling, Mazen K Khalil

  • 1Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH 44195, USA.

Archives of Internal Medicine
|June 29, 2011
PubMed

Insights

In patients with normal systolic function, moderate to severe diastolic dysfunction (DD) independently predicts mortality. Mild DD, however, does not significantly impact survival rates in this population.

Area of Science:

  • Cardiology
  • Echocardiography
  • Prognostic Studies

Background:

  • Diastolic dysfunction (DD) is linked to higher mortality with impaired systolic function.
  • Prognostic data for DD in patients with normal systolic function are limited.

Purpose of the Study:

  • To investigate the prognostic impact of diastolic dysfunction (DD) in patients with normal systolic function.

Main Methods:

  • Retrospective review of 36,261 outpatient echocardiograms (1996-2005) with normal systolic function (ejection fraction ≥55%).
  • Diastolic function graded as normal, mild, moderate, or severe using echocardiographic Doppler variables.
  • Propensity analysis used to compare outcomes between groups.

Main Results:

  • Diastolic dysfunction was present in 65.2% of patients, with mild DD being most common.
  • Unadjusted survival rates worsened with increasing DD severity (P < .001).
  • After propensity matching, moderate (HR, 1.58) and severe (HR, 1.84) DD independently predicted increased mortality (P < .001 for each).

Conclusions:

  • Moderate and severe diastolic dysfunction are independent predictors of mortality in patients with normal ejection fraction.
  • Mild diastolic dysfunction, despite its prevalence, did not significantly affect survival in this cohort.
Abstract

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