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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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Prognostic impact of diastolic dysfunction in systolic heart failure-A cross-project analysis from the German

Claus Lüers1, Frank Edelmann2,3, Rolf Wachter2

  • 1University of Oldenburg, European Medical School Oldenburg-Groningen, Germany.

Clinical Cardiology
|May 4, 2017
PubMed

Insights

Diastolic dysfunction (DD) provides important prognostic information in heart failure patients with reduced ejection fraction. Its impact is most significant in those with non-severe systolic dysfunction (SD).

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Echocardiography

Background:

  • Investigating the prognostic significance of diastolic dysfunction (DD) in heart failure (HF) patients with systolic dysfunction (SD).
  • Assessing the modifying role of DD in HF patients with reduced left ventricular ejection fraction (LVEF).

Purpose of the Study:

  • To determine if echocardiographic evaluation of diastolic function offers additional prognostic information in patients with systolic dysfunction.
  • To analyze the combined prognostic impact of systolic and diastolic dysfunction in heart failure.

Main Methods:

  • Echocardiographic study of 1046 heart failure patients with LVEF <50%.
  • Patients were followed for a median of 5 years.
  • Systolic dysfunction (SD) and diastolic dysfunction (DD) were categorized as non-severe or severe based on LVEF and E/E' values, respectively.

Main Results:

  • Severe SD significantly increased risk for all endpoints (death, hospitalization).
  • Severe DD also independently increased mortality risk.
  • A significant interaction was observed: severe DD substantially increased risk in moderate SD, but added little risk in severe SD.

Conclusions:

  • Diastolic function evaluation provides crucial additional prognostic information in HF patients with reduced LVEF.
  • The prognostic impact of DD, particularly on mortality, is most relevant in patients with non-severe systolic dysfunction.
Abstract

Keywords:
Diastolic FunctionEchocardiographyEpidemiologyHeart Failure With Preserved Ejection FractionHeart Failure With Reduced Ejection FractionSystolic Function

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