Abstract 2279: Impact Of Diastolic Dysfunction On Mortality In Patients With Normal Systolic Function: Observations From 36,419 Echocardiographic Studies.
Background Abnormal diastolic function as assessed by Doppler echocardiography is associated with a worse prognosis in heart failure and in post myocardial infarction patients. The prevalence and prognostic importance in a general population has not been established
Aim To assess in out-patients with normal systolic function the incidence of diastolic dysfunction and to compare the long term mortality during follow-up according to degree of diastolic dysfunction.
Methods All patients who had an outpatient echocardiogram from 1996 to 2006 with normal systolic function as defined by an ejection fraction of greater or equal to 55% were included. Diastolic function was classified as normal, abnormal relaxation (stage 1), pseudonormal (stage 2) and restrictive (stage 3). Individual mortality was obtained by searching the Social Security database using individual social security numbers.
Results A total of 36,419 patients were included, 47% male, average age 58 years, median follow-up 3.4 years with an overall mortality of 8.9%. The majority of patients had abnormal relaxation (59.8%) with incidence of normal diastolic function 34.9%, pseudonormal 4.8% and restrictive 0.35%. The lowest mortality rate was in the normal group with only 3.6% of deaths in this group where as 26.8% of deaths occurred in the restrictive group. (Figure 1⇓)
Conclusions In this outpatient setting in patient with normal EF, the most common diastology dysfunction pattern was abnormal relaxation. Worsening diastolic function was associated with an increased mortality rate.