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LV diastolic dysfunction worsens LEAD outcomes

03 Jun 2020

Left ventricular (LV) diastolic dysfunction increases the risk of major adverse cardiac and cerebrovascular events (MACCEs) in patients with lower extremity artery disease (LEAD), a recent study has shown.

The researchers enrolled 200 LEAD patients (mean age, 72±9 years; 66 percent male) who had undergone echocardiography. LV dysfunction was diagnosed according to the American Society of Echocardiography or European Association of Cardiovascular Imaging. The primary outcome was MACCE, defined as a composite of death, hospitalization for heart failure, stroke, or myocardial infarction. Participants were observed for an average or 32±21 months.

Thirty-one percent of patients had LV diastolic dysfunction. These patients showed a significantly higher 3-year cumulative incidence of the primary endpoint as compared with their no-dysfunction comparators (35 percent vs 23 percent; p=0.01). This was driven by the individual components of death (28 percent vs 16 percent; p=0.01) and heart failure hospitalization (10 percent vs 7 percent; p=0.01). Myocardial infarction and stroke prevalence were comparable between subgroups.

Multivariate Cox proportional hazards analysis confirmed that LV diastolic dysfunction was a significant predictor for MACCE (hazard ratio [HR], 1.96, 95 percent confidence interval [CI], 1.09–3.55; p=0.03). The same was true for critical limb ischaemia (HR, 2.52, 95 percent CI, 1.24–5.10; p=0.01).

“These findings suggest that patients with LEAD should be evaluated not only for LV systolic function but also for diastolic function in echocardiography,” said researchers.

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Most Read Articles
06 Jul 2020
Routinely used for treating cardiovascular diseases, statins have been shown to benefit other conditions, and new evidence suggests that using the drug at high intensity reduces the risk of hip or knee replacement, an effect that may be specific to rheumatoid arthritis.
Jairia Dela Cruz, 06 Jul 2020
Following vegan and vegetarian diets, which offer plenty of what is good for health, has been reported to have a downside: an increased risk of depression and anxiety, especially for younger adults.
Pearl Toh, 29 Jun 2020
Having migraine during midlife appears to be associated with a higher risk of developing dementia in later life, according to a large population-based longitudinal Danish study presented at the AHS* 2020 Virtual Meeting, indicating that migraine may be a risk factor for dementia.
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