Patient Outcomes by Ventricular Systolic and Diastolic Function
Background Left ventricular dysfunction is characterized by systolic and diastolic parameters, leading to heart failure (HF) with reduced or preserved ejection fraction (EF), respectively. The goal of this study is to examine the impact of left ventricular systolic and diastolic dysfunction (DD) on...
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Wiley
2024-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.033211 |
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| author | Jacqueline Levene Andrew Voigt Floyd Thoma Suresh Mulukutla Aditya Bhonsale Krishna Kancharla Alaa Shalaby N.A. Mark Estes Sandeep Jain Samir Saba |
| author_facet | Jacqueline Levene Andrew Voigt Floyd Thoma Suresh Mulukutla Aditya Bhonsale Krishna Kancharla Alaa Shalaby N.A. Mark Estes Sandeep Jain Samir Saba |
| author_sort | Jacqueline Levene |
| collection | DOAJ |
| description | Background Left ventricular dysfunction is characterized by systolic and diastolic parameters, leading to heart failure (HF) with reduced or preserved ejection fraction (EF), respectively. The goal of this study is to examine the impact of left ventricular systolic and diastolic dysfunction (DD) on patient outcomes. Methods and Results Two cohorts were used in this analysis: Cohort A included 136 455 patients with EF ≥50%, stratified by the presence and grade of DD. Cohort B included 16 850 patients with EF <50%, stratified by EF quartiles. Patients were followed to the end points of all‐cause death and cardiovascular, HF, or cardiac arrest hospitalizations. Over a median follow‐up of 3.42 years, 23 946 (16%) patients died and 31 113 (20%), 13 305 (9%), and 1269 (1%) were hospitalized for cardiovascular, HF, or cardiac arrest causes, respectively. With adjustment for comorbidities, the risk of all‐cause mortality and of cardiovascular and HF hospitalizations increased steadily with increasing grade of DD in patients with normal EF, and even more so in patients with worsening EF. The risk of hospitalization for cardiac arrest in patients with grade III DD, however, was comparable to that of patients with EF <25% (hazard ratio, 1.00 [95% CI, 0.98–1.01]) and worse than that of patients in better EF quartiles. Conclusions Although systolic dysfunction is associated with a greater risk of overall death and HF hospitalizations than DD, the risk of cardiac arrest in patients with grade II and III DD is comparable to that of patients with moderate and severe systolic dysfunction, respectively. Future studies are needed to examine treatment strategies than can improve these outcomes. |
| format | Article |
| id | doaj-art-80ab7da3a4f54cfd86a360cd56f06d2a |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-80ab7da3a4f54cfd86a360cd56f06d2a2025-08-20T02:26:40ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-02-0113410.1161/JAHA.123.033211Patient Outcomes by Ventricular Systolic and Diastolic FunctionJacqueline Levene0Andrew Voigt1Floyd Thoma2Suresh Mulukutla3Aditya Bhonsale4Krishna Kancharla5Alaa Shalaby6N.A. Mark Estes7Sandeep Jain8Samir Saba9Heart and Vascular Institute at the University of Pittsburgh School of Medicine Pittsburgh PA USAHeart and Vascular Institute at the University of Pittsburgh School of Medicine Pittsburgh PA USAHeart and Vascular Institute at the University of Pittsburgh School of Medicine Pittsburgh PA USAHeart and Vascular Institute at the University of Pittsburgh School of Medicine Pittsburgh PA USAHeart and Vascular Institute at the University of Pittsburgh School of Medicine Pittsburgh PA USAHeart and Vascular Institute at the University of Pittsburgh School of Medicine Pittsburgh PA USAHeart and Vascular Institute at the University of Pittsburgh School of Medicine Pittsburgh PA USAHeart and Vascular Institute at the University of Pittsburgh School of Medicine Pittsburgh PA USAHeart and Vascular Institute at the University of Pittsburgh School of Medicine Pittsburgh PA USAHeart and Vascular Institute at the University of Pittsburgh School of Medicine Pittsburgh PA USABackground Left ventricular dysfunction is characterized by systolic and diastolic parameters, leading to heart failure (HF) with reduced or preserved ejection fraction (EF), respectively. The goal of this study is to examine the impact of left ventricular systolic and diastolic dysfunction (DD) on patient outcomes. Methods and Results Two cohorts were used in this analysis: Cohort A included 136 455 patients with EF ≥50%, stratified by the presence and grade of DD. Cohort B included 16 850 patients with EF <50%, stratified by EF quartiles. Patients were followed to the end points of all‐cause death and cardiovascular, HF, or cardiac arrest hospitalizations. Over a median follow‐up of 3.42 years, 23 946 (16%) patients died and 31 113 (20%), 13 305 (9%), and 1269 (1%) were hospitalized for cardiovascular, HF, or cardiac arrest causes, respectively. With adjustment for comorbidities, the risk of all‐cause mortality and of cardiovascular and HF hospitalizations increased steadily with increasing grade of DD in patients with normal EF, and even more so in patients with worsening EF. The risk of hospitalization for cardiac arrest in patients with grade III DD, however, was comparable to that of patients with EF <25% (hazard ratio, 1.00 [95% CI, 0.98–1.01]) and worse than that of patients in better EF quartiles. Conclusions Although systolic dysfunction is associated with a greater risk of overall death and HF hospitalizations than DD, the risk of cardiac arrest in patients with grade II and III DD is comparable to that of patients with moderate and severe systolic dysfunction, respectively. Future studies are needed to examine treatment strategies than can improve these outcomes.https://www.ahajournals.org/doi/10.1161/JAHA.123.033211deathdiastolic dysfunctionejection fractionhospitalizationmyocardial function |
| spellingShingle | Jacqueline Levene Andrew Voigt Floyd Thoma Suresh Mulukutla Aditya Bhonsale Krishna Kancharla Alaa Shalaby N.A. Mark Estes Sandeep Jain Samir Saba Patient Outcomes by Ventricular Systolic and Diastolic Function Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease death diastolic dysfunction ejection fraction hospitalization myocardial function |
| title | Patient Outcomes by Ventricular Systolic and Diastolic Function |
| title_full | Patient Outcomes by Ventricular Systolic and Diastolic Function |
| title_fullStr | Patient Outcomes by Ventricular Systolic and Diastolic Function |
| title_full_unstemmed | Patient Outcomes by Ventricular Systolic and Diastolic Function |
| title_short | Patient Outcomes by Ventricular Systolic and Diastolic Function |
| title_sort | patient outcomes by ventricular systolic and diastolic function |
| topic | death diastolic dysfunction ejection fraction hospitalization myocardial function |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.033211 |
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