Abstract
Background: Left ventricular end-diastolic diameter (LVEDD) is a common indicator in echocardiogram, and increased LVEDD is correlated with left ventricular (LV) insufficiency. However, the relationship between LVEDD and mortality in patients with coronary artery disease (CAD) is uncertain. Methods: This study enrolled 33,147 patients with CAD who had undergone transthoracic echocardiography between January 2007 and December 2018 in Cardiorenal Improvement (CIN) study (ClinicalTrials.gov NCT04407936). These patients were divided into four groups according to the quartile of LVEDD (Quartile 1: LVEDD≤43 mm, Quartile 2: 43<LVEDD≤46 mm, Quartile 3: 46<LVEDD≤51 mm, Quartile 4: LVEDD>51 mm) and were categorized into two groups (Quartile 1-3 versus Quartile 4). Survival curves were generated with the Kaplan-Meier method. The restricted cubic splines and cox proportional hazards models were used to investigate the association with LVEDD and all-cause mortality. Results: In our study, there were a total of 33,147 patients, whose average age was 63.0±10.6 years and 24.01% of them were female. In the average follow-up period of 5.2 years, a totally of 4,288 patients died. After adjusting for confounding factors, patients with the larger LVEDD (Quartile 4) remain had a 1.19-fold risk for all-cause mortality (95% confidence interval: 1.09 to 1.30) compared with the lower quartile (Quartile 1-3). Conclusions: Enlarged LVEDD was an independent predictor of all-cause mortality in patients with CAD. LVEDD measurements may be helpful for risk stratification and providing therapeutic direction for the management of CAD patients.
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