Diastolic heart dysfunction and acute coronary syndrome

Abstract

Diastolic heart dysfunction is defined as an inability of the left ventricle to relax, distend and fill during diastole. Diagnosis of diastolic cardiac dysfunction is based on echocardiography. Assessment of left ventricular filling pressures (LVP) in the acute phase of acute coronary syndrome (ACS) is not common practice. The objective of our study is to evaluate LVP and demonstrate the prognostic value of the irassessment in the acute phase of ACS. We prospectively included 683 patients admitted to the cardiac intensive care unit of CHU Ibn-Rochd Casablanca during the year 2017, for an ACS with or without a persistent ST-elevation. All patients had transthoracic cardiac echocardiography within 48 hours of admission. The average age of our patients was 56.5 ± 18 years, with extremes of 38 and 78 years. There was a clear male predominance (sex ratio 7/2). LVP were high in 214 patients (31.3% of cases), isolated in 62 patients and associated with systolic heart failure in the remaining cases. Assessment of the LVP was a predictor of mortality ( P = 0.01) and occurrence of major cardiovascular events at 6 months of follow-up ( P = 0.001). The study of the diastolic function and especially the assessment of LVP in the acute phase of ACS makes it possible to refine the stratification of the patients admitted for ACS and to identify a group of at-risk patients likely to benefit from a more specific treatment.