Is Low Ejection Fraction Sufficient to Define the Prognosis of a

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Is Low Ejection Fraction Sufficient to
Define the Prognosis of a Patient or
Should we Characterize the Type of
Dyastolic Dysfunction?
Citelli, José E.; Villarraga, Héctor R.;
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.
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