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Redefining diastolic dysfunction grading: combination of E/A ≤0.75 and deceleration time >140 ms and E/ε' ≥10.
- Source :
-
JACC. Cardiovascular imaging [JACC Cardiovasc Imaging] 2014 Aug; Vol. 7 (8), pp. 749-58. Date of Electronic Publication: 2014 Jul 16. - Publication Year :
- 2014
-
Abstract
- Objectives: This study sought to examine left atrial (LA) mechanics and the prognostic impact of patients with echocardiographic findings of E/A ratio ≤0.75, deceleration time (DcT) of mitral E-wave >140 ms, but E/ε' ≥10.<br />Background: Traditional diastolic dysfunction (DD) grading system could not classify every patient into a specific group. We considered the group of patients with E/A ≤0.75, DcT >140 ms, but E/ε' ≥10 (proposed new DD grade) as a new group in the DD grading system.<br />Methods: A total of 1,362 consecutive patients were stratified according to the new DD grading system, and the LA volumes, strain, and strain rates were measured by 2-dimensional speckle-tracking analysis. All patients were followed up to determine cardiac death and major adverse cardiac events.<br />Results: An E/A ≤0.75, DcT >140 ms, but E/ε' ≥10 was observed in 227 patients (17%). LA volumes in patients with the new DD grade were between those of the impaired relaxation group and the pseudonormal group. LA strain of the new DD grade was similar to that of the pseudonormal group, whereas LA booster function was preserved as in the impaired relaxation group. During a mean follow-up of 3.0 ± 1.1 years, 25 patients had cardiac death and 61 had major adverse cardiac events. Event-free survival for major adverse cardiac events of the new DD grade was worse than that of the impaired relaxation group but similar to that of the pseudonormal group.<br />Conclusions: The new DD grade is frequently observed and has a prognosis similar to that of the pseudonormal group but significantly worse than that of the impaired relaxation group. However, LA booster function was maintained at the expense of LA volume enlargement. Thus, the new grade should be a distinct entity for routine DD grading.<br /> (Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Aged, 80 and over
Diastole
Disease-Free Survival
Female
Humans
Male
Middle Aged
Mitral Valve physiopathology
Observer Variation
Predictive Value of Tests
Reproducibility of Results
Retrospective Studies
Severity of Illness Index
Stress, Mechanical
Time Factors
Ventricular Dysfunction, Left mortality
Ventricular Dysfunction, Left physiopathology
Atrial Function, Left
Echocardiography, Doppler
Mitral Valve diagnostic imaging
Ventricular Dysfunction, Left diagnostic imaging
Ventricular Function, Left
Subjects
Details
- Language :
- English
- ISSN :
- 1876-7591
- Volume :
- 7
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- JACC. Cardiovascular imaging
- Publication Type :
- Academic Journal
- Accession number :
- 25051944
- Full Text :
- https://doi.org/10.1016/j.jcmg.2014.05.002