Evolution and outcome of diastolic dysfunction

Achong, Naomi, Wahi, Sudhir and Marwick, Thomas H. (2009) Evolution and outcome of diastolic dysfunction. Heart, 95 10: 813-818. doi:10.1136/hrt.2008.159020


Author Achong, Naomi
Wahi, Sudhir
Marwick, Thomas H.
Title Evolution and outcome of diastolic dysfunction
Journal name Heart   Check publisher's open access policy
ISSN 1355-6037
Publication date 2009-05-15
Year available 2008
Sub-type Article (original research)
DOI 10.1136/hrt.2008.159020
Volume 95
Issue 10
Start page 813
End page 818
Total pages 6
Editor Adam D. Timmis
Place of publication United Kingdom
Publisher B M J Group
Language eng
Subject C1
Formatted abstract
Background: Diastolic dysfunction (DD) is highly prevalent and associated with increased morbidity and mortality, but its natural history remains poorly defined.

Objective: This cohort study sought to characterise the influence of clinical features, medical therapy and echocardiographic parameters on the progression of DD.

Methods
: We identified 926 consecutive patients (aged 62 (14) years, 221 women) with DD and preserved systolic function. A repeat echocardiogram was performed in 199 patients 1 year after the baseline study (average 3.6 (1.4) years). Follow-up for 4.8 (2.5) years was 97% complete for the major endpoint of all-cause mortality. Cox regression analyses were performed to identify the associations of mortality.

Results:
Over follow-up, 142 patients died and 22 were admitted with heart failure. The independent predictors of death were age, hyperlipidaemia, co-morbid disease and restrictive filling. The degree of diastolic dysfunction remained stable in 52%, deteriorated in 27% and improved in 21%. There was a greater use of medical therapy in those with stable or worsening diastolic function; when the protective effects of these agents were taken into account in a multivariate model, improvement in diastolic dysfunction was associated with a survival benefit.

Conclusion: DD is associated with all-cause mortality, independent of the presence of a major co-morbidity. The degree of DD remains stable in about 50% of patients, the population whose diastolic function improves over time has a more favourable outcome.
Keyword VENTRICULAR SYSTOLIC FUNCTION
Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2009 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Tue, 16 Jun 2009, 00:10:53 EST by Cameron Harris on behalf of Office of Sponsored Research