Prevalence and prognosis of left ventricular diastolic dysfunction in the elderly: The PROTEGER Study.
BACKGROUND
Left ventricular diastolic dysfunction (LVDD) was reported as a significant predictor of mortality, mainly in patients with heart failure. However, prospective data are scarce in the hospitalized elderly population.


METHODS
We studied the association of severe LVDD, defined by conventional echocardiographic parameters, with cardiovascular and all-cause mortality in a population of 331 hospitalized elderly patients with a history of cardiovascular disease (mean age +/- SD, 87 +/- 7 years). After a mean follow-up of 378 days, 110 deaths occurred.


RESULTS
Compared with left ventricular systolic dysfunction (LVSD), subjects with severe diastolic dysfunction had a similar prevalence (12% vs 10%) and similar cardiovascular and all-cause mortality (18% vs 19%, 49% vs 50%). Both cardiovascular and all-cause mortality increased progressively and significantly with increasing number of diagnostic criteria of LVDD (P = .035, P = .013) and reached 48.7% for all-cause mortality when at least 2 criteria were met. In addition to cardiovascular risk factors and LVSD, severe LVDD provided incremental and independent prognostic information of all-cause mortality with increased chi(2) value of Cox regression model (48.1 vs 43.5, P = .022).


CONCLUSIONS
Severe LVDD, diagnosed by conventional echocardiography, has similar prevalence and prognosis as LVSD and provides incremental prognostic value, which highlights the clinical significance of routine evaluation of LVDD in risk assessment strategies of the hospitalized elderly.
Zhang
Yi
Y
Paris Descartes University, Diagnosis and Therapeutic Center, Hôtel-Dieu, Paris, France.
Safar
Michel E
ME
Iaria
Pierre
P
Agnoletti
Davide
D
Protogerou
Athanase D
AD
Blacher
Jacques
J
D000368:Aged; D000369:Aged, 80 and over; D003971:Diastole; D004562:Electrocardiography; D005260:Female; D005602:France / Q000453:epidemiology; D006333:Heart Failure / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D011379:Prognosis; D013318:Stroke Volume; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000401:mortality