The diastolic dysfunction, a parameter detectable by a simple echocardiogram, is able to predict adverse events in patients with heart failure with reduced ejection fraction and should be included in the guidelines as a risk ‘score’. These are the conclusions reached by the cardiologists of Pope John XXIII of Bergamo, in collaboration with fellow researchers from Boston and other European and American centers, from the analysis of data on a large case histories of over 1,000 patients.
The study was recently published in International Journal of Cardiology, an influential scientific journal in the cardiovascular field. The study results suggest updating the guidelines that cardiologists around the world follow to predict hospitalizations for heart failure or the risk of death in patients with heart failure, the second leading cause of death in Italy every year.
Throughout life, one in five people you are at risk of developing this cardiovascular condition, which is the inability of the heart to pump enough blood around the body. Today, cardiologist specialists are able to classify, for each patient, an approximate estimate of the prognosis in the years to come, thanks to predictive algorithms based on certain parameters, the so-called prognostic ‘risk scores’. According to this study, the algorithms should now be updated, including diastolic dysfunction, a parameter that can always be detected by the control echocardiographic examinations.
“With fellow researchers from Boston we evaluated the probability of adverse events, taking into account the risk factors used in clinical practice, of 1,155 patients suffering from heart failure with reduced ejection fraction – he explained. Mauro Gori of the Cardiology of Pope John he is principal investigator of the firm -. Our data show that diastolic dysfunction is the first factor to be used to stratify the risk of these patients, better than what can be done with commonly used parameters, such as natriuretic peptides. Across all subgroups, diastolic dysfunction was a large independent prognostic factor for heart failure or death in patients with reduced ejection fraction. This opens up a useful consideration for us specialists. This data must be taken into consideration when evaluating a patient’s condition to establish the most effective therapeutic program ”.
“Papa Giovanni is a reference center for heart failure in advanced or acute stages and for patients suffering from chronic heart failure, both with reduced and preserved systolic function. We treat patients with individualized multi-drug therapies, respiratory and / or circulation assistance systems, ultrafiltration or dialysis techniques, electrical therapy, ventricular assistance implants – underlined Michele Senni, director of Cardiology and director of the Cardiovascular Department of the ASST Pope John XXIII -. Studies like this have immediate clinical fallout. In fact, we will immediately include in our protocols the measurement of diastolic dysfunction as an element to be considered for defining the prognosis and therapies for our patients “.
“Between our hospital and that of Boston A relationship based on clinical research in the cardiovascular field and on fellowship experiences in the United States of our medical specialists has been in progress for some time – commented Fabio Pezzoli, medical director of ASST Papa Giovanni XXIII -. It is from collaborations like this that important results come out in identifying the most effective treatments for our patients ”.
International Journal of Cardiology, “Combining diastolic dysfunction and natriuretic peptides to risk stratify patients with heart failure with reduced ejection fraction”