Usefulness of diastolic dysfunction score in predicting long-term prognosis of acute myocardial infarction patients with preserved ejection fraction

Abstract

Abstract Background To investigate the usefulness of left ventricular diastolic dysfunction (LVDD) score in the prediction of future major cardiovascular events (MACEs) in acute myocardial infarction (AMI) patients with preserved ejection fraction (EF). Methods Among 2,539 AMI patients from January 2012 to December 2015, a total of 1,374 patients with preserved EF and no atrial fibrillation were enrolled and were followed up for 3 years. Four parameters which were used for the categorization of DD in the current 2016 recommendation of American Society of Echocardiography (ASE) (septal e' <7cm/s, E/e' >14, tricuspid regurgitation velocity >2.8m/s, and LAD >40mm) were used for DD scoring. The integer score was assigned to each parameter as 1 point. The development of MACEs including death, recurrent MI, any revascularization, or hospitalization due to heart failure (HHF) was evaluated. Results Study subjects were divided into 5 groups by the current 2016 ASE criteria; LVDD score 0 (n=354), score 1 (n=496), score 2 (n=333), score 3 (n=139), and score 4 (n=52). During 3 years of clinical follow up, MACEs were developed in 271 patients; 142 death, 74 recurrent MI, 99 revascularization, and 32 HHF. MACEs were significantly increased as LVDD scores were increased; MACEs in LVDD score 0 (n=43, 12.1%), score 1 (n=73, 14.7%), score 2 (n=73, 21.9%), score 3 (n=51, 36.7%), and score 4 (n=31, 59.6%), (ptrend <0.001). On Kaplan-Meier survival curve analysis, MACEs free survival was significantly lower as LVDD scores were increased (Figure 1). Conclusion The present study demonstrated that MACEs were significantly increased as LVDD scores were increased in AMI patients with preserved EF. Therefore, it is suggested that this novel scoring system by using the current 2016 ASE criteria for diastolic function evaluation may provide comprehensive risk assessment and thus would be useful in predicting upcoming CV events in AMI patients with preserved EF. MACE free survival according to the LVDD Funding Acknowledgement Type of funding source: None