Severity of diastolic dysfunction predicts myocardial infarction
Tanmay A Gokhale1, Mehak Dhande1, Suresh Mulukutla1
1From the Heart and Vascular Institute and the Department of Medicine at the University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
International Journal of Cardiology. Heart & Vasculature
|February 6, 2025
Summary
Diastolic dysfunction (DD) independently predicts myocardial infarction (MI) risk in patients with preserved ejection fraction. Higher DD grades significantly increase MI risk, aiding patient risk stratification.
Area of Science:
- Cardiology
- Echocardiography
- Preventive Medicine
Background:
- Diastolic dysfunction (DD) is a known mortality predictor.
- The specific impact of DD on myocardial infarction (MI) risk remains unclear.
- Research is needed to define DD's role in MI risk for patients with preserved ejection fraction.
Purpose of the Study:
- To investigate if diastolic dysfunction (DD) is an independent predictor of myocardial infarction (MI) risk.
- To assess the relationship between DD severity and MI risk in patients with preserved ejection fraction.
Main Methods:
- Observational study of 129,476 patients with normal systolic function and ≥3 months follow-up.
- Diastolic dysfunction (DD) graded per contemporary guidelines.
- Myocardial infarction (MI) identified via inpatient diagnosis.
Main Results:
- Diastolic dysfunction (DD) present in 17.6% of patients; higher grades associated with older age and comorbidities.
- Survival free from myocardial infarction (MI) decreased with increasing DD severity.
- Multivariate analysis confirmed DD as an independent MI predictor (HRs: Grade I: 1.48, Grade II: 1.84, Grade III: 2.90).
Conclusions:
- Increased risk of myocardial infarction (MI) is associated with diastolic dysfunction (DD).
- Higher grades of DD correlate with significantly elevated MI risk.
- DD severity can potentially aid in stratifying patients for myocardial infarction (MI) risk.
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