Importance of Diastolic Function for the Prediction of Arrhythmic Death : A Prospective, Observer-Blinded, Long-Term Study
BACKGROUND: Patients with ischemic or dilated cardiomyopathy and reduced left ventricular ejection fraction (LVEF) face a high risk for ventricular arrhythmias. Exact grading of diastolic function might improve risk stratification for arrhythmic death.
METHODS: We prospectively enrolled 120 patients with ischemic, 60 patients with dilated cardiomyopathy, and 30 patients with normal LVEF. Diastolic function was graded normal (N) or dysfunction grade I to III. Primary outcome parameter was arrhythmic death (AD) or resuscitated cardiac arrest (RCA).
RESULTS: Normal diastolic function was found in 23 (11%) patients, dysfunction grade I in 107 (51%), grade II in 31 (14.8%), and grade III in 49 (23.3%) patients, respectively. After an average follow-up of 7.0±2.6 years, AD or RCA was observed in 28 (13.3%) and 33 (15.7%) patients, respectively. Nonarrhythmic death was found in 41 (19.5%) patients. On Kaplan-Meier analysis, patients with dysfunction grade III had the highest risk for AD or RCA (P<0.001). This finding was independent from the degree of LVEF dysfunction and was observed in patients with LVEF≤35% (P=0.001) and with LVEF>35% (P=0.014). Nonarrhythmic mortality was the highest in patients with dysfunction grade III. This was true for patients with LVEF≤35% (P=0.009) or >35% (P<0.001). In an adjusted model for relevant confounding factors, grade III dysfunction was associated with a 3.5-fold increased risk for AD or RCA in the overall study population (hazard ratio=3.52; P<0.001).
CONCLUSIONS: Diastolic dysfunction is associated with a high risk for AD or RCA regardless if LVEF is ≤35% or >35%. Diastolic function grading might improve risk stratification for AD.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
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| Enthalten in: |
Circulation. Arrhythmia and electrophysiology - 13(2020), 2 vom: 01. Feb., Seite e007757 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Pezawas, Thomas [VerfasserIn] |
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| Links: |
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| Themen: |
Cardiomyopathy, dilated |
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| Anmerkungen: |
Date Completed 17.08.2020 Date Revised 01.02.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1161/CIRCEP.119.007757 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM305425463 |
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| 100 | 1 | |a Pezawas, Thomas |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Importance of Diastolic Function for the Prediction of Arrhythmic Death |b A Prospective, Observer-Blinded, Long-Term Study |
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| 500 | |a Date Completed 17.08.2020 | ||
| 500 | |a Date Revised 01.02.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Patients with ischemic or dilated cardiomyopathy and reduced left ventricular ejection fraction (LVEF) face a high risk for ventricular arrhythmias. Exact grading of diastolic function might improve risk stratification for arrhythmic death | ||
| 520 | |a METHODS: We prospectively enrolled 120 patients with ischemic, 60 patients with dilated cardiomyopathy, and 30 patients with normal LVEF. Diastolic function was graded normal (N) or dysfunction grade I to III. Primary outcome parameter was arrhythmic death (AD) or resuscitated cardiac arrest (RCA) | ||
| 520 | |a RESULTS: Normal diastolic function was found in 23 (11%) patients, dysfunction grade I in 107 (51%), grade II in 31 (14.8%), and grade III in 49 (23.3%) patients, respectively. After an average follow-up of 7.0±2.6 years, AD or RCA was observed in 28 (13.3%) and 33 (15.7%) patients, respectively. Nonarrhythmic death was found in 41 (19.5%) patients. On Kaplan-Meier analysis, patients with dysfunction grade III had the highest risk for AD or RCA (P<0.001). This finding was independent from the degree of LVEF dysfunction and was observed in patients with LVEF≤35% (P=0.001) and with LVEF>35% (P=0.014). Nonarrhythmic mortality was the highest in patients with dysfunction grade III. This was true for patients with LVEF≤35% (P=0.009) or >35% (P<0.001). In an adjusted model for relevant confounding factors, grade III dysfunction was associated with a 3.5-fold increased risk for AD or RCA in the overall study population (hazard ratio=3.52; P<0.001) | ||
| 520 | |a CONCLUSIONS: Diastolic dysfunction is associated with a high risk for AD or RCA regardless if LVEF is ≤35% or >35%. Diastolic function grading might improve risk stratification for AD | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a cardiomyopathy, dilated | |
| 650 | 4 | |a death, sudden, cardiac | |
| 650 | 4 | |a heart failure | |
| 650 | 4 | |a primary prevention | |
| 650 | 4 | |a risk assessment | |
| 700 | 1 | |a Burger, Achim Leo |e verfasserin |4 aut | |
| 700 | 1 | |a Binder, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Diedrich, André |e verfasserin |4 aut | |
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