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Is Low Ejection Fraction Sufficient to
Define the Prognosis of a Patient or
Should we Characterize the Type of
Citelli, José E.; Villarraga, Héctor
Sánchez, Jairo; Badiel, Marisol;
Olaya, Pastor; Rosso, Fernando
Echocardiographic and Hemodinamic Laboratory.
Fundación Valle del Lili, Cali, Colombia
Introduction:Low Ejection Fraction (EF) and restrictive physiology are known factors of poor prognosis. However we do not know if other types of diastolic dysfunction carry also a bad prognosis.
Objective: Define the prognostic value of the non restrictive and restrictive patterns in patients with low EF.
Design: Observational. Bi-directional cohort.
Methods: Patients were selected from the echocardiographic registry between May, 1998 and March 2000 with an EF of <40% with complete diastolic evaluation, an d classified as restrictive (R) and non restrictive (NR). Follow-up was performed by a physician and status regarding death or alive, functional class (FC) and cause of death was done by a phone call. Results: 83 patients, mean age 66 years, EF 30%±8.2, 42 patients were classified in Group R. Mean follow-up of 11±7 months. Mortality rate in group R was 23.8% and 9.7% in group NR. The OR of mortality and FC III-IV group R compared with NR was 5.44 (CI95% 1.92-15.73, p=0.001). There wasn't differences in both groups with respect to FE and demographic characteristics.
Conclusion: Non restrictive diastolic physiology in patients with systolic dysfunction provide a better prognosis than those with restrictive physiology, independent of EF, therefore in large trials their subtypes should be further characterized due to its good prognosis.
2nd Virtual Congress of Cardiology
Dr. Florencio Garófalo
Dr. Raúl Bretal
Dr. Armando Pacher
Technical Committee - CETIFAC
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