Prognosis of patients with left ventricular diastolic pressure abnormality: a long-term survival study in patients without coronary artery disease.
BACKGROUND
Given that an elevated left ventricular (LV) end-diastolic pressure reflects an abnormality of diastolic function, we analyzed the outcome of this finding in patients without coronary artery disease (CAD).


OBJECTIVE
The degree to which diastolic dysfunction influences mortality has been confounded in most studies by CAD and advanced age.


METHODS
We performed a retrospective study of 876 patients with normal coronary arteries on arteriography. Of these, 115 patients had a left ventricular end-diastolic pressure of > or = 15 mmHg with an ejection fraction (EF) > or = 50%. We compared the mortality in this group (Group A) with the reported outcome in the general population, adjusted for age, gender, and race, as well as the mortality of a group of patients from the same cohort (Group B) with both diastolic and systolic dysfunction (n = 60), defined as a LVEF < 50%.


RESULTS
Follow-up was for a mean of 63 months. In Group A, all-cause mortality was 5% (six patients); two deaths were from cardiac causes. The mean annual mortality in this group (1.2%) was similar to the adjusted annual mortality of the general population (1.1%), and it was significantly lower than the annual mortality (6%) in Group B (p < 0.03).


CONCLUSIONS
Our study results indicate that diastolic dysfunction with a normal EF, in the absence of CAD and systolic dysfunction, has an excellent prognosis over a long period (5-6 years).
Brady
Jennifer
J
Department of Cardiology, New Jersey Medical School/University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA. jenniferzimmer@hotmail.com
Dwyer
Edward M
EM
D000368:Aged; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000379:methods; D003327:Coronary Disease / Q000000981:diagnostic imaging; D003971:Diastole; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology*; D015996:Survival Rate; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy