Restrictive Filling Pattern in the Echo Lab

Background: Restrictive filling pattern is associated with unfavorable prognosis. Cardiac interventions may change the natural history of these patients.

Objectives: The objectives of this study were to investigate the prevalence of restrictive filling pattern among routine echocardiographic examinations and its association with morbidity and mortality in the modern era.

Methods. Database of our hospital was retrieved for echocardiographic examinations in which restrictive filling pattern was found during 2013. The clinical and echocardiographic data of these patients were analyzed and summarized.

Results. Among 8000 patients who had undergone echocardiographic examination in our hospital in 2013, restrictive filling pattern was found in 256, of them in 134 restrictive filling pattern was newly diagnosed in 2013. Age was 69±13, 70% males; hypertension 81%, diabetes 60% and ischemic heart disease 53% were found in 81%, 60% and 53% respectively. LVEF was 42±16%. Severe valvular abnormalities were found in 18%. During follow up (29±15 months) 40% died. Patients that died underwent any cardiac interventions less often 26% versus 45%, p< 0.03. The strongest predictor of mortality was moderate or more aortic stenosis, mortality risk= 73%, p=0.005. Conservative strategy was associated with mortality=48%, p

Renal failure was found be an independent predictor of mortality.

Conclusions. Prevalence of restrictive filling among echocardiographic studies is 3.2%, in a half of them, the restrictive filling pattern is a new diagnosis. These patients, in the absence of cardiac intervention, have a high mortality rate. In patients with restrictive filling invasive cardiac strategy should be considered early, if appropriate.