Abstract 16232: Effect of Left Ventricular Diastolic Dysfunction on Incident Heart Failure and Mortality is Independent of Left Ventricular Geometry, Mass and Systolic Function
Background: Left ventricular (LV) diastolic dysfunction (DD) often occurs in patients with abnormal LV geometry and mass. It is not clear if DD-associated adverse cardiovascular (CV) outcomes are mediated by abnormal LV geometry and mass. We hypothesized that the effect of DD on CV outcomes would be independent of LV geometry and mass.
Methods: Of the 5795 community-dwelling adults ≥65 years in the Cardiovascular Health Study, 2980 were without baseline heart failure (HF) and had baseline echocardiographic data on E/A ratio and left atrial dimension (LAD). An abnormal LAD was used as a marker of DD in those with pseudo-normal E/A ratio. DD was defined as normal (E/A 0.75–1.5, normal LAD), grade 1 (E/A<0.75, regardless of LAD), grade 2 (E/A 0.75–1.5, abnormal LAD), and grade 3 (E/A>1.5, abnormal LAD). Cox regression models to find association between DD and outcomes adjusted for demographics (age, race, sex, body mass index, smoke-pack years, and alcohol consumption per week), CV comorbidities (hypertension, diabetes mellitus, coronary artery disease, stroke, and peripheral arterial disease), LV geometry (relative wall thickness), LV mass index, and systolic function
Results: Participants had a mean age of 73 (±5) years, 61% women and 5% African American. Incident HF and death occurred in 19% and 41% of participants respectively over a mean follow-up of 10.5 years. Hazard ratios (95% CI) for the association of DD with centrally-adjudicated incident HF and all-cause mortality are displayed in the Table.
Conclusions: LV diastolic dysfunction predicts incident HF and all-cause mortality independent of LV geometry, mass, or systolic function.
- © 2010 by American Heart Association, Inc.