TY - JOUR
AR - JICOA-2021-1-106
TI - Prevalence and Outcome of Advanced Left Ventricular Diastolic Dysfunction among Consecutive Patients Referred for Echocardiography
AU - Mady, Moriel
AU - Adi , Butnaru
AU - Marc , Klutstein
AU - Rivka , Farkash
AU - Michael , Glikson
AU - David , Rosenmann
AU - Shmuel , Gottlieb
JO - Journal of Integrative Cardiology Open Access
PY - 2021
DA - Thu 14, Jan 2021
SN - 2674-2489
DO - http://dx.doi.org/10.31487/j.JICOA.2021.01.06
UR - https://www.sciencerepository.org/prevalence-and-outcome-of-advanced-left-ventricular-diastolic-dysfunction_JICOA-2021-1-106 
KW - Left ventricle, diastolic dysfunction, prevalence, mortality, outcome
AB - Aim: To assess the prevalence of advanced left ventricular diastolic dysfunction (LVDD) in a cohort of
consecutive patients referred for echocardiography and its association with mortality.
Methods: The cohort included 4,481 (85% hospitalized) patients who underwent echocardiography, had
normal or preserved LV systolic function and diastolic function assessment. LVDD was graded as none or
mild (0/I) and advanced grade (II/III). Mortality data were derived from the National Israeli Population
Registry.
Results: LVDD grade II/III was found in 1,262 patients (28%), was more prevalent among the elderly,
females, diabetic and hypertensive patients. Independent predictors associated with LVDD grade II/III (OR;
95% CI) were: age (1-year increment) 1.015 (1.01-1.02), p<0.001; female sex 1.2 (1.04-1.39), p=0.012;
hypertension 1.53 (1.30-1.80), p<0.001, while ischaemic heart disease was negatively associated 0.73 (0.63-
0.85), p<0.001. 1-year mortality rates were higher among grade II/III LVDD as compared to grade 0/I DD
patients, 19% vs. 10.2%, respectively, p<0.0001. Independent predictors for all-cause mortality after
adjusting for pertinent variables were: LVDD grade II/III 1.72 (1.40-2.11); age (1-year increment) 1.08
(1.07-1.09) and diabetes 1.54 (1.26-1.70), p<0.001 for all.
Conclusion: LVDD grade II/III was more prevalent among the elderly, females, diabetic and hypertensive
patients. Advanced LVDD was a strong independent predictor for all-cause mortality after adjustment for
risk factors. Intensive pharmacological therapies at an earlier stage of LVDD may improve patients’
outcome.