Abstract 10598: Persistently Worsened Diastolic Dysfunction Score Evaluated by Multiple Echocardiographic Parameters Predicts Poor Prognosis in Heart Failure Patients with Preserved Ejection Fraction
The promising echocardiographic parameter predicting prognosis of heart failure with preserved ejection fraction (HFpEF) remains to be determined. We reported that diastolic dysfunction score (DDS) which consist of combined echocardiographic parameters may be a feasible schema predicting prognosis of patients with HFpEF. However, echocardiographic parameters may be altered by hemodynamic changes of patients. Therefore, we evaluated whether the changes of DDS can predict poor prognosis in patients with HFpEF.
Transthoracic echocardiography was performed in 117 consecutive patients with HFpEF (EF ≥50%) who were hospitalized for heart failure at both admission and discharge (56 males, mean age 75 ± 11 years). We defined that diastolic dysfunction score (DDS) was formed by assigning 1 point each for the presence of the abnormal value for deceleration time (DT, positive if<140), the ratio of E-wave to the peak early mitral annular velocities (E/e', positive if>15), and left atrial volume index (LAVI, positive if>43). DDS could successfully risk stratify patients with HFpEF for cardiac event. We classified patients for improved DDS group (Group 1, n=46), no changes of DDS group (Group 2, n=49), and worsened DDS group (Group 3, n=22). There were 46 cardiac events (39%) during median follow up period of 465 days (range 17-1150 days).
Cardiac event rates significantly increased from Group 1 to 3 (Group 1, 26%; Group 2, 39%; Group 3, 68%). Group 3 had higher cardiac event risk than Group 1 (Group 3, hazard ratio 3.09 ; P<0.01).Kaplan-Meier survival analysis showed that the changes of DDS could reliability risk stratify patients with HFpEF for cardiac event (Figure).In conclusion, measurement of serial DDS may be a feasible tool for predicting prognosis in patients with HFpEF.
- © 2011 by American Heart Association, Inc.