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The impact of left ventricular diastolic dysfunction for the prognosis in patients with lower extremity arterial

Jen-Kuang Lee1,2,3, Juey-Jen Hwang1, Fu-Tien Chiang1

  • 1Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.

ESC Heart Failure
|June 25, 2020
PubMed

Insights

Left ventricular diastolic dysfunction (LVDD) is a significant predictor of mortality and major adverse cardiac events (MACE) in patients with lower extremity arterial disease (LEAD). Early identification of LVDD may improve outcomes for LEAD patients.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Echocardiography

Background:

  • Lower extremity arterial disease (LEAD) and left ventricular diastolic dysfunction (LVDD) share common risk factors.
  • The prognostic implications of LVDD in LEAD patients are not fully understood.

Purpose of the Study:

  • To investigate the impact of LVDD on clinical outcomes in patients with LEAD.
  • To assess the association between LVDD severity and prognosis in LEAD.

Main Methods:

  • Classified LVDD using the American Society of Echocardiography guidelines.
  • Conducted survival analysis for mortality and major adverse cardiac events (MACE).
  • Utilized multivariate Cox regression analysis in 464 LEAD patients and 221 controls.

Main Results:

  • Prevalence and severity of LVDD were proportional to LEAD severity (Rutherford class).
  • LVDD grade significantly predicted MACE (HR=2.11) and mortality (HR=1.47) in LEAD patients.
  • This association remained significant even after endovascular therapy (EVT).

Conclusions:

  • The degree of LVDD is a significant predictor of MACE and mortality in LEAD patients.
  • Further large-scale studies are needed to confirm the benefit of early LVDD identification in LEAD management.
Abstract

Keywords:
Cardiac diastolic dysfunctionHeart failure with preserved ejection fractionLower extremity arterial diseasePrognosis

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