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PREDICTORS OF LONG-TERM CLINICAL OUTCOME IN PATIENTS WITH MILD DIASTOLIC DYSFUNCTION ON ECHO
1722 JACC April 5, 2016 Volume 67, Issue 13
Non Invasive Imaging (Echocardiography, Nuclear, PET, MR and CT) PREDICTORS OF LONG-TERM CLINICAL OUTCOME IN PATIENTS WITH MILD DIASTOLIC DYSFUNCTION ON ECHO Poster Contributions Poster Area, South Hall A1 Sunday, April 03, 2016, 9:45 a.m.-10:30 a.m. Session Title: Emerging Applications of Echocardiography: Part I Abstract Category: 29. Non Invasive Imaging: Echo Presentation Number: 1183-266 Authors: Mikhail Narezkin, Kevin Shah, Anya Narezkina, Amin Sabet, Daniel Blanchard, Anthony DeMaria, University of California San Diego, La Jolla, CA, USA
Background: Uncertainty continues regarding factors that predict adverse clinical outcomes in asymptomatic patients with mild (Grade I) diastolic dysfunction (MDD) as impaired relaxation on echo.
Methods: We identified 535 consecutive asymptomatic MDD patients (by ASE criteria) in 2010 and followed them through August 2015. Exclusions were existing cardiovascular disease, LVEF<50%, or significant co-morbidities. Clinical outcomes were heart failure, stroke, supraventricular tachyarrhythmias, or all cause death. Variables examined were age, gender, hypertension (HTN), LVEF, mitral E and A, E/A ratio, E deceleration time, tissue Doppler annular septal (E’sep) and lateral velocity (E’lat), pulmonary vein S/D ratio, peak TR velocity (TRV), left atrial volume index, and LV wall thickness.
Results: The study population was mean age 67 years, 38% male, mean EF 67%, and 59% with HTN. During a mean follow-up of 5.2 years, 83 patients (16%) had events: CHF (n=36); atrial fibrillation (n=37); stroke (n=23); SVT (n=5); or death (n=7). In univariate analyses age, E’sep, E’lat, TRV were associated with the outcome (p<0.05). In multivariate analysis E’lat remained predictive for clinical progression (p=0.019) with a trend for E’sep. Clinical events occurred in 31% of patients with E’lat ≤ 5 cm/s but only 7% of those with E’lat ≥ 11 cm/s. Conclusions: Annular relaxation velocity is related to clinical outcomes in patients with MDD.
Non Invasive Imaging (Echocardiography, Nuclear, PET, MR and CT) PREDICTORS OF LONG-TERM CLINICAL OUTCOME IN PATIENTS WITH MILD DIASTOLIC DYSFUNCTION ON ECHO Poster Contributions Poster Area, South Hall A1 Sunday, April 03, 2016, 9:45 a.m.-10:30 a.m. Session Title: Emerging Applications of Echocardiography: Part I Abstract Category: 29. Non Invasive Imaging: Echo Presentation Number: 1183-266 Authors: Mikhail Narezkin, Kevin Shah, Anya Narezkina, Amin Sabet, Daniel Blanchard, Anthony DeMaria, University of California San Diego, La Jolla, CA, USA
Background: Uncertainty continues regarding factors that predict adverse clinical outcomes in asymptomatic patients with mild (Grade I) diastolic dysfunction (MDD) as impaired relaxation on echo.
Methods: We identified 535 consecutive asymptomatic MDD patients (by ASE criteria) in 2010 and followed them through August 2015. Exclusions were existing cardiovascular disease, LVEF<50%, or significant co-morbidities. Clinical outcomes were heart failure, stroke, supraventricular tachyarrhythmias, or all cause death. Variables examined were age, gender, hypertension (HTN), LVEF, mitral E and A, E/A ratio, E deceleration time, tissue Doppler annular septal (E’sep) and lateral velocity (E’lat), pulmonary vein S/D ratio, peak TR velocity (TRV), left atrial volume index, and LV wall thickness.
Results: The study population was mean age 67 years, 38% male, mean EF 67%, and 59% with HTN. During a mean follow-up of 5.2 years, 83 patients (16%) had events: CHF (n=36); atrial fibrillation (n=37); stroke (n=23); SVT (n=5); or death (n=7). In univariate analyses age, E’sep, E’lat, TRV were associated with the outcome (p<0.05). In multivariate analysis E’lat remained predictive for clinical progression (p=0.019) with a trend for E’sep. Clinical events occurred in 31% of patients with E’lat ≤ 5 cm/s but only 7% of those with E’lat ≥ 11 cm/s. Conclusions: Annular relaxation velocity is related to clinical outcomes in patients with MDD.