OS 27-03 IMPAIRED DIASTOLIC RECOVERY BEFORE DISCHARGE IS ASSOCIATED WITH RE-HOSPITALIZATION WITH HYPERTENSIVE HEART FAILURE.

OBJECTIVE: The aim of this study was to investigate the impact of diastolic functional recovery on pre-discharge echocardiography on future adverse events in the patients with hypertensive heart failure (HHF).

DESIGN AND METHOD: A total of 136 hospitalized patients with HHF were divided into 2 groups according to the change of diastolic function on pre-discharge echocardiography; the improving group (n = 65, 47.9 ± 14.4years, 49 males) vs non-improving group (n = 71, 52.6 ± 14.8 years, 52males). HHF was defined as symptom/signs of HF accompanied by left ventricular hypertrophy and uncontrolled hypertension, and the improvement of diastolic function was defined as in the present study. Major adverse cardiac events (MACEs) including death and rehospitalization due to HF were compared.

RESULTS: The improvement of systolic dysfunction was observed in 50 patients (36.5%), and the improvement of diastolic dysfunction was observed in 66 patients (48.5%). The level of N-terminal pro B-type natriuretic peptide and serum creatinine were significantly higher, and the level of hemoglobin was significantly lower in the non-improving group than in the improving group. The other baseline characteristics and the prescribed medications were not different between the groups. During ± months of clinical follow up, MACEs were developed in patients; death (0%), 22 rehospitalization (16.2%). MACEs were significantly higher in the non-improving group than in the improving group (22.9% vs 9.2%, p = 0.032). Although the changes of systolic function was not a predictor of MACEs, the impaired diastolic functional recovery was significant independent predictor of MACEs (RR = 2.870, p = 0.043, CI = 1.032-7.976).

CONCLUSIONS: The present study demonstrated that the impaired diastolic functional recovery at the time of discharge in patients with HHF, regardless of the change of systolic function, is a predictor of MACEs. The change of diastolic function should be carefully monitored and would be useful in the risk stratification of HHF.