Mady Moriel,Adi  Butnaru,Marc  Klutstein,Rivka  Farkash,Michael  Glikson,David  Rosenmann,Shmuel  Gottlieb,
Prevalence and Outcome of Advanced Left Ventricular Diastolic Dysfunction among Consecutive Patients Referred for Echocardiography
Journal of Integrative Cardiology Open Access
2021
2674-2489
http://dx.doi.org/10.31487/j.JICOA.2021.01.06
https://www.sciencerepository.org/prevalence-and-outcome-of-advanced-left-ventricular-diastolic-dysfunction_JICOA-2021-1-106 
Abstract: 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.Keywords: Left ventricle, diastolic dysfunction, prevalence, mortality, outcome