Background: Diastolic dysfunction is not routinely assessed in patients undergoing coronary angiography. The purpose of this study was to assess the association of diastolic dysfunction with clinical, laboratory, echocardiographic and angiographic features in patients undergoing coronary angiography.
Patients and methods: This was a single center prospective study. One thousand consecutive patients undergoing coronary angiography were enrolled. Diastolic dysfunction was assessed by Doppler echocardiography in 508 patients. It was defined significant if pseudonormal or restrictive pattern was observed.
Results: Patients with diastolic dysfunction were more likely to be older (71.9 vs 68.7 years, p=0.001), be female (35.0% vs 25.6%, p=0.032), to have chronic kidney disease (28.6 % vs 16.2%, p=0.001).
They were more likely to have pulmonary hypertension (80.2% vs 35.5%, p<0.001), aortic stenosis (25.8% vs 16.9%, p=0.021) and atrial fibrillation (32.8% vs 12.3%, p<0.0001). Patients with significant diastolic dysfunction had lower ejection fraction (44.5% vs 50.5%, p<0.0001) and higher pulmonary artery pressure (53.9 vs 41.3 mm Hg). These patients were also more likely to be hypertensive and diabetic. There was no difference nor in the extend of the coronary artery disease as demonstrated by coronary angiography.
In the logistic regression model, which included the above mentioned variables, only age (p<0.0001), gender (p=0.002), diabetes (p=0.013), atrial fibrillation (p=0.001), and presence of significant diastolic dysfunction (p<0.0001) were independently associated with pulmonary hypertension.
Conclusions: Significant diastolic dysfunction is associated with much higher prevalence of renal failure, aortic stenosis, pulmonary hypertension and atrial fibrillation.
