Document Detail


Different prognostic significance of right and left ventricular diastolic dysfunction in heart failure.
MedLine Citation:
PMID:  10492839     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Left (LV) and right (RV) ventricular diastolic dysfunction is common in heart failure but the prognostic value of RV diastolic dysfunction is not known. HYPOTHESIS: As a follow-up to a previously undertaken study, this study was carried out to investigate whether LV and RV diastolic dysfunction affect prognosis differently and, in addition, whether changes in diastolic filling patterns over time correlate with clinical outcome. METHODS: We studied a cohort of 105 patients (mean age 62.7 +/- 1.3 years, 66% male) with heart failure (ejection fraction < 50%) by Doppler echocardiography in both RV and LV. RESULTS: An LV restrictive filling pattern (RFP) was present in 48% of the patients and, when compared with non-RFP subgroups, it was associated with poorer systolic function, higher New York Heart Association functional class, and higher cardiac mortality at 1 year (all p < 0.001). The coexistence of an LV-RFP and poor LV systolic function (ejection fraction < 25%) markedly decreased the 1-year survival that was significant when compared with other subgroups (p = 0.001). In contrast, RV diastolic dysfunction that occurred in 21% of patients was not a prognostic factor for mortality either alone or in combination with LV diastolic dysfunction, but predicted nonfatal hospital admissions for heart failure or unstable angina (p = 0.016). CONCLUSION: An LV restrictive filling pattern is a powerful predictor of a poor prognosis, especially when combined with low ejection fraction, but in this study RV diastolic dysfunction did not appear to be an independent predictor of subsequent mortality.
Authors:
H C Yu; J E Sanderson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical cardiology     Volume:  22     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-10-28     Completed Date:  1999-10-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  504-12     Citation Subset:  IM    
Affiliation:
Department of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, China.
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MeSH Terms
Descriptor/Qualifier:
Diastole
Echocardiography, Doppler
Female
Follow-Up Studies
Heart Failure / mortality,  physiopathology*,  ultrasonography
Humans
Male
Middle Aged
Morbidity
Prognosis
Prospective Studies
Regression Analysis
Stroke Volume
Survival Analysis
Ventricular Dysfunction, Left / physiopathology*,  ultrasonography
Ventricular Dysfunction, Right / physiopathology*,  ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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