Abstract 16748: The Severity of Left Ventricular Diastolic Dysfunction is Associated With Higher Prevalence of Myocardial Fibrosis
Introduction: Myocardial fibrosis is likely an important cause of left ventricular (LV) diastolic dysfunction which is associated with important morbidity and mortality. In this study we investigated the relationship of the severity of LV diastolic dysfunction with prevalence of myocardial fibrosis.
Hypothesis: The severity of LV diastolic dysfunction is related to higher prevalence of myocardial fibrosis characterized by cardiac MRI (CMR).
Methods: Consecutive patients undergone transthoracic echocardiography and CMR within 7 days at a single center (2007-2015) were selected. LV systolic function and dimension, left atrial (LA) volume and late gadolinium enhancement (LGE) were assessed by CMR. Myocardial fibrosis was defined by LGE as infarct pattern or non-infarct pattern. LV diastolic function was assessed by echocardiographic Doppler imaging following the algorithm from the latest ASE guideline including mitral inflow velocity (E, A), early diastolic annular myocardial longitudinal velocity (e’), tricuspid regurgitation and LA volume index.
Results: There were 710 patients included in the analysis. Median age was 55 years [range 17-90 years] and 65% were male. LGE was found in 326 (46%) individuals with non-infarct fibrosis seen in 30% and infarct pattern in 16%. Among 510 patients whose diastolic dysfunction was determined by guideline, those with diastolic dysfunction (N=236) were much more likely to have LGE than those without (N=274) (76% vs 45%, p<0.0001). The higher prevalence of LGE was associated with higher grading of diastolic dysfunction with 27% in subjects of normal diastolic function, 56% in grade 1, 70% in grade 2 and 60% in grade 3 of diastolic dysfunction (p<0.01). There were 200 patients who fell into the category of “cannot determine diastolic dysfunction grade”. Their prevalence of LGE was 46%, higher than those with normal diastolic function (p<0.0001).
Conclusions: The severity of LV diastolic dysfunction is significantly associated with the prevalence of myocardial fibrosis determined by CMR in a large clinical cohort with diverse clinical conditions. Our findings support the pivotal role of myocardial tissue property in the development of LV diastolic dysfunction.
Author Disclosures: L. Wang: None. R. Tverskaya: None. J.J. Cao: None.
- © 2016 by American Heart Association, Inc.