Coronary artery diseasePrevalence and Prognosis of Asymptomatic Left Ventricular Diastolic Dysfunction in Ambulatory Patients With Coronary Heart Disease
Section snippets
Patients
Patients were enrolled in the Heart and Soul Study, a prospective cohort study investigating the influence of psychosocial factors on cardiovascular events. Methods were described previously.5 Administrative databases were used to identify outpatients with documented coronary artery disease at 2 Department of Veterans Affairs medical center databases (San Francisco and Palo Alto, California), 1 university-based medical center (University of California Medical Center–San Francisco), and 9 public
Results
Of 693 patients with LV ejection fraction ≥50% and no history of HF, 455 (66%) had normal LV diastolic function, 166 (24%) had impaired relaxation (mild LV diastolic dysfunction), and 72 (10%) had pseudonormal or restrictive filling (moderate to severe LV diastolic dysfunction). Compared with patients with normal LV diastolic function, those with LV diastolic dysfunction were older; more likely to have experienced a previous myocardial infarction, stroke, or revascularization; and less likely
Discussion
We found that moderate to severe LV diastolic dysfunction was present in 10% of outpatients with CHD who had no systolic dysfunction or history of HF. The presence of asymptomatic moderate to severe LV diastolic dysfunction predicted a more than sixfold increased risk of incident HF and an almost fourfold increased risk of death from heart disease. The increased risk of cardiovascular events associated with asymptomatic LV diastolic dysfunction was similar to that observed for patients with
References (12)
- et al.
Recommendations for quantification of Doppler echocardiography: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography
J Am Soc Echocardiogr
(2002) - et al.
ACC/AHA guidelines for the clinical application of echocardiography: executive summaryA report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Clinical Application of Echocardiography). Developed in collaboration with the American Society of Echocardiography
J Am Coll Cardiol
(1997) - et al.
Outcome of heart failure with preserved ejection fraction in a population-based study
N Engl J Med
(2006) - et al.
Systolic and diastolic heart failure in the community
JAMA
(2006) - et al.
Trends in prevalence and outcome of heart failure with preserved ejection fraction
N Engl J Med
(2006) - et al.
Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic
JAMA
(2003)
Cited by (0)
This work was supported by grants from the Department of Veterans Affairs, Washington, DC; Grant No. R01 HL079235 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland; the American Federation for Aging Research (Paul Beeson Scholars Program), New York, New York; the Robert Wood Johnson Foundation (Faculty Scholars Program), Princeton, New Jersey, the Ischemia Research and Education Foundation; and the Nancy Kirwan Heart Research Fund, San Francisco, California.