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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

Published on: September 1, 2014

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Importance of Diastolic Function for the Prediction of Arrhythmic Death: A Prospective, Observer-Blinded, Long-Term

Thomas Pezawas1, Achim Leo Burger1, Thomas Binder1

  • 1Department of Medicine II, Division of Cardiology, Medical University of Vienna, Austria (T.P., A.L.B., T.B.).

Circulation. Arrhythmia and Electrophysiology
|January 17, 2020
PubMed

Insights

Severe diastolic dysfunction significantly increases the risk of arrhythmic death or cardiac arrest in patients with cardiomyopathy, regardless of left ventricular ejection fraction (LVEF). Grading diastolic function aids in better risk stratification for these events.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Heart Failure Research

Background:

  • Patients with cardiomyopathy and reduced left ventricular ejection fraction (LVEF) are at high risk for ventricular arrhythmias.
  • Accurate grading of diastolic function may enhance risk stratification for sudden cardiac death.

Purpose of the Study:

  • To investigate the association between diastolic function grade and the risk of arrhythmic death (AD) or resuscitated cardiac arrest (RCA).
  • To determine if diastolic function grading improves risk stratification for adverse cardiac events, independent of LVEF.

Main Methods:

  • Prospective enrollment of 120 patients with ischemic cardiomyopathy, 60 with dilated cardiomyopathy, and 30 with normal LVEF.
  • Diastolic function was graded from normal (N) to grade III; primary outcomes were AD or RCA.
  • Kaplan-Meier analysis and adjusted models were used to assess risk.

Main Results:

  • Grade III diastolic dysfunction was associated with the highest risk for AD or RCA (P<0.001), independent of LVEF.
  • This association held true for patients with LVEF ≤35% (P=0.001) and LVEF >35% (P=0.014).
  • Grade III dysfunction conferred a 3.5-fold increased risk for AD or RCA in the overall population (HR=3.52; P<0.001).

Conclusions:

  • Diastolic dysfunction significantly elevates the risk of AD or RCA, irrespective of LVEF severity.
  • Diastolic function grading is a valuable tool for improving risk stratification in patients prone to ventricular arrhythmias.
Abstract

Keywords:
cardiomyopathy, dilateddeath, sudden, cardiacheart failureprimary preventionrisk assessment

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