DIASTOLIC LEFT VENTRICULAR DYSFUNCTION IN SUDDEN CARDIAC ARREST SURVIVORS
CCC ePoster Library. Al-Shaheen A. 10/26/19; 280494; 229
Dr. Abdullah Al-Shaheen
Dr. Abdullah Al-Shaheen
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Abstract
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BACKGROUND: The Registry of Unexplained Cardiac Arrest (CASPER) includes patients without demonstrable structural heart disease who have survived cardiac arrest. The majority of these events remain unexplained despite detailed genotypic and phenotypic investigations, follow-up and family screening. The recent identification of genetic variants associated with cardiomyopathy in the CASPER registry implies that some of these patients may have an arrhythmogenic phase prior to a mechanical phase that presents without evident left ventricular systolic dysfunction, although their diastolic function remains unknown. Sudden death has also been shown to account for ~20% of deaths in patients with heart failure and preserved ejection fraction. Here, we assess the echocardiographic measures of diastolic function among patients from the CASPER registry.

METHODS AND RESULTS: We conducted a retrospective study of patients from British Columbia in the CASPER registry who experienced a cardiac arrest between April 1988 and November 2016. Patients with no obstructive coronary artery disease on angiography and preserved left ventricular ejection fraction (defined as ≥50%) were included. Of the 65 patients identified, 44 had echocardiograms suitable for the assessment of diastolic function within 1 year before or after their cardiac arrest. Diastolic dysfunction was graded based on the 2016 American Society of Echocardiography (ASE) Diastolic Function Guidelines. Patients with and without abnormal diastolic function were compared for various clinical characteristics. The study group included 44 patients (36% female) patients with a mean age of 42 + 14 years. The majority (86%) had normal diastolic function. Three patients (7%) showed indeterminate diastolic function, and 3 patients (7%) displayed abnormal diastolic function (1 with mild diastolic dysfunction, 1 with moderate diastolic dysfunction, and 1 with abnormal diastolic function that could not be classified). All 3 patients with abnormal diastolic function had a history of hypertension. Other risk factors for diastolic dysfunction such as obesity, diabetes, and dyslipidemia were absent.

CONCLUSION: To our knowledge, this is the first study to examine diastolic function in a cohort of patients with unexplained cardiac arrest without overt structural heart disease. This preliminary data set suggests that the prevalence of diastolic dysfunction within this population is higher than the general population. Further characterization of these patients is warranted.
BACKGROUND: The Registry of Unexplained Cardiac Arrest (CASPER) includes patients without demonstrable structural heart disease who have survived cardiac arrest. The majority of these events remain unexplained despite detailed genotypic and phenotypic investigations, follow-up and family screening. The recent identification of genetic variants associated with cardiomyopathy in the CASPER registry implies that some of these patients may have an arrhythmogenic phase prior to a mechanical phase that presents without evident left ventricular systolic dysfunction, although their diastolic function remains unknown. Sudden death has also been shown to account for ~20% of deaths in patients with heart failure and preserved ejection fraction. Here, we assess the echocardiographic measures of diastolic function among patients from the CASPER registry.

METHODS AND RESULTS: We conducted a retrospective study of patients from British Columbia in the CASPER registry who experienced a cardiac arrest between April 1988 and November 2016. Patients with no obstructive coronary artery disease on angiography and preserved left ventricular ejection fraction (defined as ≥50%) were included. Of the 65 patients identified, 44 had echocardiograms suitable for the assessment of diastolic function within 1 year before or after their cardiac arrest. Diastolic dysfunction was graded based on the 2016 American Society of Echocardiography (ASE) Diastolic Function Guidelines. Patients with and without abnormal diastolic function were compared for various clinical characteristics. The study group included 44 patients (36% female) patients with a mean age of 42 + 14 years. The majority (86%) had normal diastolic function. Three patients (7%) showed indeterminate diastolic function, and 3 patients (7%) displayed abnormal diastolic function (1 with mild diastolic dysfunction, 1 with moderate diastolic dysfunction, and 1 with abnormal diastolic function that could not be classified). All 3 patients with abnormal diastolic function had a history of hypertension. Other risk factors for diastolic dysfunction such as obesity, diabetes, and dyslipidemia were absent.

CONCLUSION: To our knowledge, this is the first study to examine diastolic function in a cohort of patients with unexplained cardiac arrest without overt structural heart disease. This preliminary data set suggests that the prevalence of diastolic dysfunction within this population is higher than the general population. Further characterization of these patients is warranted.
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