Interactive role of diastolic dysfunction and ventricular remodeling in asymptomatic subjects at increased risk of heart failure

AbstractDiastolic dysfunction (DD) and left ventricular remodeling (LVR) characterize patients at risk for heart failure (HF). To assess the prognostic impact of different diastolic function algorithms and a complex LVR classification (CRC) in asymptomatic subjects with preserved ejection fraction (EF) at risk for HF. We analyzed 1923 asymptomatic patients (male 43%; age 57, 33 –76 years) with at least one cardiovascular risk factor and preserved (>  50%) EF. We used three algorithms for LV diastolic function assessment (Paulus et al. in Eur Heart J 28(20):2539–2550, 2007; Nagueh et al. in J Am Soc Echocardiogr 22(2):107–133, 2009, Eur Heart J Cardiovasc Imaging 17(12):1321–1360, 2016), and two algorithms for LVR (classic and CRC). We c onsidered a composite end-point: cardiac death and hospitalization for HF. The highest presence of DD was diagnosed by Nagueh 2009 (211, 11%), while the prevalence according to Nagueh 2016 (63 patients, 3.2%) turned out to be the lowest (p <  0.001 vs the other algorithms). According to CRC, 780 (48.6%) patients had normal or physiologic hypertrophy, 298 (15.5%) concentric remodeling, 85 (4.4%) eccentric remodeling, 294 (15.3%) concentric hypertrophy, 39 (2%) mixed hypertrophy, 80 (4.1%) dilated hypertrophy, 73 (3.7%) eccentric hypert rophy and 294 (15.3%) were unclassifiable. After 39-month follow-up (261 events, 13.6%), Cox-regression (adjusted for age, gender, history of stable ischemic heart disease, classic remodeling...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research