PMID- 31836269
OWN - NLM
STAT- MEDLINE
DCOM- 20210727
LR  - 20210727
IS  - 1097-6795 (Electronic)
IS  - 0894-7317 (Linking)
VI  - 33
IP  - 2
DP  - 2020 Feb
TI  - The Association between Left Ventricular Diastolic Dysfunction and Myocardial 
      Scar and Their Collective Impact on All-Cause Mortality.
PG  - 161-170
LID - S0894-7317(19)31022-3 [pii]
LID - 10.1016/j.echo.2019.09.022 [doi]
AB  - BACKGROUND: Left ventricular diastolic dysfunction (DD) and myocardial scar are 
      important contributors to cardiovascular morbidity and mortality. The aim of this 
      study was to test the hypothesis that myocardial scar is a substrate of DD and 
      that collectively they contribute to increased risk for all-cause mortality. 
      METHODS: The study included 607 consecutive patients who underwent 
      echocardiography and cardiac magnetic resonance imaging within 1 week. DD was 
      assessed by echocardiography according to the contemporary guidelines and 
      myocardial scar by late gadolinium enhancement (LGE). All-cause mortality was the 
      main outcome. RESULTS: Scar prevalence was significantly higher comparing no DD 
      with mild and advanced DD (25%, 61%, and 80%, respectively; P < .001), and scar 
      burden was greater by semiquantitative LGE scores (1.4 +/- 3.4, 4.8 +/- 6.3, and 
      6.8 +/- 8.8, respectively; P < .001). After 10 years of follow-up, 50 patients 
      (8.2%) had died. The mortality incidence was significantly higher comparing no DD 
      with mild and advanced DD (2.5, 17.3, and 55.7 deaths per 1,000 person-years, 
      respectively; P < .001). It was also higher in patients with higher LGE scores 
      (4.3, 22.7, and 35.2 deaths per 1,000 person-years in groups with LGE scores of 
      0, 1-6, and >/=7, respectively; P < .001). The risk for death was higher among 
      patients with both DD and scar. The additive interaction of DD and scar for 
      mortality was significant (P < .001). In the multivariate Cox 
      proportional-hazards analysis, DD and scar were associated with mortality 
      (P < .001). CONCLUSIONS: There is a strong link between the echocardiographic 
      findings of DD and the morphologic changes of myocardial tissue. DD assessed 
      according to contemporary guidelines effectively differentiates mortality risk. 
      The additive interaction of DD and scar on mortality risk highlights the pivotal 
      role of myocardial tissue characterization in patients with DD.
CI  - Copyright (c) 2019 American Society of Echocardiography. Published by Elsevier Inc. 
      All rights reserved.
FAU - Wang, Lin
AU  - Wang L
AD  - St. Francis Hospital, The Heart Center, Roslyn, New York; State University of New 
      York at Stony Brook, Stony Brook, New York.
FAU - Singh, Harsimar
AU  - Singh H
AD  - St. Francis Hospital, The Heart Center, Roslyn, New York.
FAU - Mulyala, Rajasekhar R
AU  - Mulyala RR
AD  - St. Francis Hospital, The Heart Center, Roslyn, New York.
FAU - Weber, Jonathan
AU  - Weber J
AD  - St. Francis Hospital, The Heart Center, Roslyn, New York.
FAU - Barasch, Eddy
AU  - Barasch E
AD  - St. Francis Hospital, The Heart Center, Roslyn, New York; State University of New 
      York at Stony Brook, Stony Brook, New York.
FAU - Cao, J Jane
AU  - Cao JJ
AD  - St. Francis Hospital, The Heart Center, Roslyn, New York; State University of New 
      York at Stony Brook, Stony Brook, New York. Electronic address: 
      jane.cao@chsli.org.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20191210
PL  - United States
TA  - J Am Soc Echocardiogr
JT  - Journal of the American Society of Echocardiography : official publication of the 
      American Society of Echocardiography
JID - 8801388
SB  - IM
MH  - Cause of Death/trends
MH  - Cicatrix/complications/*diagnosis
MH  - Echocardiography/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Ventricles/*diagnostic imaging/physiopathology
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*complications/mortality/physiopathology
MH  - New York/epidemiology
MH  - Retrospective Studies
MH  - Survival Rate/trends
MH  - Ventricular Dysfunction, Left/diagnosis/mortality/*physiopathology
OTO - NOTNLM
OT  - Cardiomyopathy
OT  - Echocardiography
OT  - Heart failure
OT  - MRI
EDAT- 2019/12/15 06:00
MHDA- 2021/07/28 06:00
CRDT- 2019/12/15 06:00
PHST- 2019/03/07 00:00 [received]
PHST- 2019/09/09 00:00 [revised]
PHST- 2019/09/09 00:00 [accepted]
PHST- 2019/12/15 06:00 [pubmed]
PHST- 2021/07/28 06:00 [medline]
PHST- 2019/12/15 06:00 [entrez]
AID - S0894-7317(19)31022-3 [pii]
AID - 10.1016/j.echo.2019.09.022 [doi]
PST - ppublish
SO  - J Am Soc Echocardiogr. 2020 Feb;33(2):161-170. doi: 10.1016/j.echo.2019.09.022. 
      Epub 2019 Dec 10.