Impact of progression of diastolic dysfunction on mortality in patients with normal ejection fraction
Wael Aljaroudi1, M Chadi Alraies, Carmel Halley
1Sydell and Arnold Miller Family Heart and Vascular Institute, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, 9500 Euclid Ave/J1-5, Cleveland, OH 44195, USA. aljarow@ccf.org
Circulation
|January 21, 2012
Summary
Worsening diastolic function in patients with normal left ventricular ejection fraction independently predicts mortality. This finding highlights the prognostic significance of diastolic dysfunction progression in cardiovascular health.
Area of Science:
- Cardiology
- Echocardiography
- Prognostic Biomarkers
Background:
- Diastolic dysfunction predicts mortality in patients with normal ejection fraction.
- Limited data exist on prognosis associated with worsening diastolic function.
Purpose of the Study:
- To investigate if worsening diastolic function is associated with increased mortality risk.
- To analyze the prognostic value of diastolic function changes in patients with preserved ejection fraction.
Main Methods:
- Retrospective review of echocardiograms from 1065 outpatients (2005-2009).
- Assessed changes in diastolic function and left ventricular ejection fraction over time.
- Used Kaplan-Meier and Cox regression for survival analysis.
Main Results:
- 72.3% had baseline diastolic dysfunction; 16% showed worsening on follow-up.
- Worsening diastolic function and decreased ejection fraction were linked to higher mortality.
- Hazard ratio for mortality was 1.78 for worsening diastolic function (P=0.003).
Conclusions:
- Worsening diastolic function independently predicts mortality in patients with normal baseline ejection fraction.
- Diastolic function progression is a significant prognostic indicator in this population.
Related Concept Videos
01:17Pathophysiology of Heart Failure
4.8K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
4.8K
01:20Mitral Regurgitation I: Introduction
1.3K
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
1.3K
01:29Heart Failure II: Pathophysiology
1.9K
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
1.9K
01:30Heart Failure IV: Classification and Diagnostic Evaluation
1.0K
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
1.0K
01:30Heart Failure V: Medical Management
626
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
626
01:30Cardiomyopathy II: Dilated Cardiomyopathy
790
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
790