Diastolic dysfunction (DD) as defined by American Society of Echocardiography (ASE) and European Society of Cardiovascular Imaging (ESCVI) guidelines is correlated with increased mortality, according to researchers presenting on the NEDA study at ESC Congress 2020. However, study authors noted that many cases remain "indeterminate," limiting the effectiveness of the guidelines' use.

The study analyzed data from the National Echo Database in Australia, which includes 436,360 adults with ≥1 diastolic function measurement linked to 100,597 deaths during 2.2 million person-years follow-up. Of these adults, ASE/EACVI guidelines could be applied in nearly 90% of cases (392,009) and, of these, 11.4% were identified as "reduced" left ventricular ejection fraction (LVEF<50%) and 88.6% were "preserved" LVEF (≥50%). However, authors noted diastolic function was indeterminate in 21.5% of preserved LVEF cases and 62.2% of reduced LVEF cases.

Across the different cases, the risk of adjusted five-year cardiovascular-related mortality was increased in patients with preserved LVEF and DD or those considered indeterminate, compared with those with DD, researchers said. However, they highlighted that when analyzed separately, mitral E velocity, septal e' velocity, E:e' ratio and LAVi "revealed clear pivot-points" of increased cardiovascular-related mortality risk. Specifically, "on adjusted basis, pivot-points of increased risk for cardiovascular-related mortality occurred at 90cm/s for E wave velocity; 9cm/s for septal e'velocity; an E:e' ratio of 9 and a LAVi of 32ml/m2, the authors said.

Clinical Topics: Heart Failure and Cardiomyopathies, Prevention, Acute Heart Failure, Hypertension

Keywords: ESC Congress, ESC20, Heart Failure, Diastole, Hypertension

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