CORRELATION OF FUNCTIONAL CLASS OF DYSPNEA WITH LEFT VENTRICULAR DIASTOLIC DYSFUNCTION

Abstract

Objective: To correlate functional class of dyspnea with left ventricular diastolic
dysfunction assessed by echocardiography.
Methodology: This was a single center descriptive study, conducted in
Cardiology department Lady Reading Hospital Peshawar from March 2011 to
October 2011. All male and female patients of any age with clinical diagnosis of
heart failure with sinus rhythm and no to minimal mitral regurgitation were
included in the study, using consecutive non-probability sampling technique. Six
minute walk test was performed to place the patients in proper NYHA Class of
dyspnea. Detailed echocardiographic study was performed to document left
ventricular diastolic dysfunction. The data was analyzed on SPSS version 16.
Spearman rank correlation coefficient was used to measure the strength of
association between pairs of variables. P-value ≤ 0.05 was considered
significant.
Results: A total of 113 patients were included. Mean age was 58.42±10.48
(35–80). Male patients were 61.9% and 38.1% were female. Most of the patients
were in NYHA Class II (34.5%) and Class III (37.2%). There was not a single
patient who had normal diastolic relaxation pattern and majority of the patients
had pseudonormal pattern of left ventricular diastolic dysfunction (60.2%)
followed by restrictive pattern, i-e; 34.5%. Mean values of Mitral inflow velocities
were; E velocity 0.6 m/sec, A velocity 0.6 m/sec, E/A 1.3. It was found that with
increasing dyspnea, left ventricular diastolic function was also declining (γ: -
0.204, p= 0.025).
Conclusion: In patients with heart failure there is significant correlation between
functional class of dyspnea and left ventricular diastolic dysfunction.