Prevalence and significance of restrictive filling pattern in an echocardiography laboratory

Marina Leitman, Marina Levitan, Vladimir Tyomkin, Zvi Vered

Research output: Contribution to journalArticlepeer-review

Abstract

Background: a cardiac restrictive filling pattern is associated with unfavorable prognoses. Cardiac interventions may change the natural history of patients. Objectives: To investigate the prevalence of restrictive filling pattern in routine echocardiographic examinations and their association with morbidity and mortality. Methods: The clinical and echocardiographic data of patients with newly diagnosed restrictive filling pattern were analyzed and summarized. Results: Among 8000 patients who underwent an echocardiographic examination in our hospital in 2013, a restrictive filling pattern was identified in 256. Of these, 134 showed a restrictive filling pattern that was newly diagnosed. Mean age was 69 years. Hypertension, diabetes, and ischemic heart disease were found in 81%, 60%, and 53%, respectively. Left ventricular ejection fraction was 42% ± 16%. Severe valvular abnormalities were found in 18%. During follow-up (29 ± 15 months), 40% of patients died. The strongest predictor of mortality (73%) was moderate or more advanced aortic stenosis, P = 0.005. Renal failure was an important independent predictor of mortality (52%, P < 0.05). A very high E/E’ ratio ≥ 20, was another independent mortality predictor (50%, P < 0.03). Patients who died were less likely to have undergone cardiac interventions than those who survived (26% vs. 45%, P < 0.03). Conclusions: Prevalence of restrictive filling among echocardiographic studies is 3.2%. In a half of these, the restrictive filling pattern is a new diagnosis. Patients who are diagnosed with a new restrictive filling pattern have higher mortality rates. Patients with restrictive filling should be evaluated thoroughly for possible coronary artery or valvular heart disease.

Original languageEnglish
Pages (from-to)543-547
Number of pages5
JournalIsrael Medical Association Journal
Volume20
Issue number9
StatePublished - Sep 2018

Keywords

  • Cardiac surgery
  • Diastolic function
  • Restrictive filling

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