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Prognostic value of left ventricular diastolic dysfunction in patients undergoing cardiac catheterization for

Hidekatsu Fukuta1, Nobuyuki Ohte, Kazuaki Wakami

  • 1Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi Mizuho-Cho Mizuho-Ku, Nagoya 467-8601, Japan.

Cardiology Research and Practice
|May 9, 2012
PubMed

Insights

Left ventricular diastolic dysfunction, indicated by impaired relaxation, significantly increases cardiovascular event risk in coronary artery disease patients. This finding holds true even after accounting for other risk factors.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Diagnostic Imaging

Background:

  • Left ventricular (LV) diastolic dysfunction is a potential contributor to cardiovascular events.
  • Accurate assessment of diastolic function is crucial for risk stratification in patients with coronary artery disease (CAD).

Purpose of the Study:

  • To investigate the association between LV diastolic dysfunction, assessed by cardiac catheterization and Doppler echocardiography, and the risk of cardiovascular events.
  • To determine the independent predictive value of specific diastolic function indices for cardiovascular outcomes in patients with CAD.

Main Methods:

  • Cardiac catheterization and Doppler echocardiography were used to assess LV diastolic function in 222 patients with CAD.
  • Key indices measured included relaxation time constant (Tau), end-diastolic pressure (EDP), early diastolic mitral annular velocity (e'), and E/e' ratio.
  • Patients were followed for cardiovascular events, including cardiac death and hospitalizations.

Main Results:

  • Impaired LV relaxation (Tau > 48 ms) and reduced early diastolic mitral annular velocity (e' < 5.8 cm/s) were significantly associated with an increased risk of cardiovascular events.
  • These associations remained significant after adjusting for traditional cardiovascular risk factors, CAD severity, and medications.
  • End-diastolic pressure (EDP), E/e' ratio, and LV ejection fraction did not show predictive value for cardiovascular events.

Conclusions:

  • LV diastolic dysfunction, specifically impaired LV relaxation, is an independent predictor of adverse cardiovascular outcomes in patients with known or suspected CAD.
  • Both cardiac catheterization (Tau) and Doppler echocardiography (e') can effectively identify patients at higher risk.
  • These findings highlight the importance of assessing diastolic function for comprehensive cardiovascular risk assessment in this population.

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