Abstract 15196: Diastolic Dysfunction by Tissue Doppler Imaging Predicts All-Cause Mortality in Patients with Cerebral Infarction
Introduction: Several clinical prediction score models have been investigated for predicting mortality in patients with cerebral infarction. However none of these include echocardiographic measures. Advanced echocardiographic modalities have shown great prognostic potential in cardiac diseases, and may be useful in patients with cerebral infarction.
Hypothesis: Tissue Doppler Imaging is an echocardiographic modality of prognostic value in patients with cerebral infarction.
Methods: 244 patients with cerebral infarction and subsequent echocardiographic examination were identified. During a median follow-up of 3 years 42 patients died.
Using Tissue Doppler Imaging in three apical projections, longitudinal mitral annular velocities were obtained in 6 segments. Cox regression models and C-statistics were performed for global and segmental e’.
Results: Patients who died during follow-up had significantly impaired systolic and diastolic function (determined by LVEF and E/e’). The risk of dying increased with decreasing global e’ (figure), being approximately 13 times higher for patients in the lowest tertile compared to patients in the highest tertile (HR=13.4 [3.2;56.3], p<0.001). Patients with significantly impaired global e’ showed increased mortality after multivariable adjustments for all clinical and echocardiographic significant predictors (HR=1.9[1.1;3.2]), per 1 cm/s decrease, p<0.05). Similar pattern was seen in segmental analyses of the e’. In contrast to e’, no conventional echocardiographic parameters remained independent predictors of mortality after multivariable adjustment.
Conclusions: Diastolic dysfunction by TDI-determined e’ is a significant predictor of all-cause mortality in patients with cerebral infarction. Applying this parameter can aid the prognostic assessment after cerebral infarction.
Author Disclosures: F.J. Olsen: None. P.G. Jørgensen: None. R. Møgelvang: None. J.S. Jensen: None. T. Fritz-Hansen: None. J. Bech: None. J.C. Sivertsen: None. T. Biering-Sørensen: None.
- © 2014 by American Heart Association, Inc.