Abstract 10885: Decreased Hydraulic Force Contributes to Diastolic Dysfunction and Associates with Survival Beyond Conventional Measures of Diastolic Dysfunction

• Published in: Circulation (New York, N.Y.) N.Y.), 2021-11, Vol.144 (Suppl_1), p.A10885-A10885
• Main Authors: Soundappan, Dhnanjay, Fung, Angus, Loewenstein, Daniel, Playford, David, Strange, Geoff, Kozor, Rebecca, Otton, James, Ugander, Martin
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.144.suppl_1.10885

IntroductionDecreased hydraulic force has recently been identified as a mechanism contributing to left ventricular (LV) diastolic dysfunction and heart failure with preserved ejection fraction (HFpEF). However, it is unclear if hydraulic forces are independently associated with survival. HypothesisDecreased diastolic hydraulic force, estimated as the atrioventricular area difference (AVAD), is associated with survival independent of conventional diastolic dysfunction measures. MethodsPatients (n=37947, median [interquartile range] 4.9 [2.9-8.0] years follow-up, 6103 events) were selected from the National Echo Database Australia based on the presence of relevant transthoracic echocardiographic measures, LV ejection fraction (LVEF) ≥ 50%, heart rate 50-100 beats/minute, the absence of moderate or severe valvular disease, pericardial disease or mitral annular calcification, and no prior cardiac surgery. AVAD was calculated as the cross-sectional area difference between the LV and left atrium (LA) using circular approximation of LV end-diastolic diameter and LA end-systolic diameter. LV diastolic dysfunction grading was performed according to 2016 guidelines. ResultsIn multivariable linear regression, AVAD was weakly associated with E/e’, e’, peak tricuspid regurgitation velocity, and LVEF (global adjusted R2=0.11, p