Abstract 577: Echocardiographic Classification of Diastolic Function Predicts Survival Better Than Catheter-measured Left Ventricular Filling Pressures
Background: Classification of diastolic function (DF) into Normal, abnormal relaxation (AR) or severe dysfunction (SDD) is predicated on identifying echocardiographic markers of elevated LV filling pressure.
Objective: To compare prognostic utilities of DF classification and catheter-measured LV pre-A pressure in predicting 4-yr mortality.
Methods: Subjects n=114, age 65±10yrs, male (62%) had echocardiogram within 2 hours of LV catheterization. LV pre-A pressure was stratified as normal (< 12mmHg) borderline (12–15mmHg) and elevated (> 15mmHg). Echocardiographic algorithm (Table 1⇓) was used to classify DF. Vital status was determined after a follow up of 41 to 51 months. Kaplan-Meier survival plots were constructed for LV pre-A and DF classes. A Cox proportional hazard model adjusting for Age, sex, LVEF was determined.
Results: Significant coronary disease was present in 79% of subjects. Mean LVEF was 53 ±14. Death occurred in 8 of 24 subjects with SDD, 5 of 33 with AR and 3 of 57 with Normal DF. The adjusted hazard associated with SDD (compared to Normal + AR) was 3.88 (CI, 1.14 –13.21) p=0.03. Likewise, 6 of 24; 3 of 26; and 7 of 64 for LVpre-A >15 mmHg; 12–15mmHg and <12mmHg respectively died. The hazard for LV PreA >15 was 1.88 (CI, 0.62–5.72) p=0.26. Figure⇓ shows survival plots.
Conclusion: Diastolic function class predicts 4-yr survival better than catheter-measured LV pre-A pressure.