Author + information
- Cesare Russo,
- Chelsea Jin,
- Lin Tao,
- Kaushal Desai,
- Alice Goshorn,
- Mark Donovan and
- Agata Ptaszynska
Background: Left ventricular diastolic dysfunction (DD) has a central role in the pathophysiology of heart failure with preserved ejection fraction (HFpEF). We assessed DD progression over time and its prognostic implications in the Irbesartan in Heart Failure with Preserved Systolic Function (I-PRESERVE) trial.
Methods: A subgroup of patients from I-PRESERVE underwent echocardiograms at baseline and at 10 months (10M). DD was categorized as absent (DD0), mild (DD1), moderate (DD2) and severe (DD3). The association of DD progression with a composite of all-cause death/CV hospitalizations was tested in Cox proportional hazards model and Kaplan Meier plots.
Results: The study sample included 448 patients (mean age 72 years, EF 64±9%, NYHA class II-IV). DD prevalence at baseline was DD0 27%, DD1 18%, DD2 30%, DD3 25%. During follow-up (mean 1256 days, range 3-2019) 146 events occurred (111 occurred after the first 10M). DD3 at baseline was associated with events (hazard ratio [HR] vs. DD0=2.33, 95% CI 1.49-3.64), whereas DD1 (HR 1.13, 95% CI 0.65-1.95) and DD2 (HR 1.25, 95% CI 0.78-2.01) were not. Among the 337 patients with DD0/DD1/DD2 at baseline, 32 (9.5%) progressed to DD3 at 10M; such progression was associated with subsequent events in univariate (KM plot in figure, HR vs. no progression 2.25, 95% CI 1.21-4.18) and multivariate analysis (HR 2.34, 95% CI 1.01-5.43).
Conclusions: In HFpEF patients, progression to severe DD over 10 months was associated with higher risk of death and CV hospitalizations.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Emerging Developments in HFpEF and Arryhthmias
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1250-272
- 2017 American College of Cardiology Foundation