Cardiovascular resource utilization in patients with diastolic dysfunction: A retrospective cohort analysis

Abstract

Introduction

Diastolic dysfunction (DD) is often linked to the development and persistence of atrial fibrillation (AF), but its impact on healthcare resource utilization (HCRU) in patients with or without AF is unclear.

Methods

Patients who received a transthoracic echocardiogram at our institution between 2010 and 2022 were included. DD was derived from the echocardiogram reports. HCRU included cardiac interventional, structural, surgical, and electrophysiology procedures, as well as diagnostic monitoring and imaging tests.

Results

A cohort of 157,043 patients (mean age 58 ± 18 years, 55 % women, 88 % White, 9 % with AF, 23 % with DD, LVEF 56 ± 8 %, BMI 30 ± 8 kg/m²) was retrospectively analyzed. The presence and severity of DD is associated with a proportional increase in HCRU, calculated as the mean annual number of cardiac procedures per year. For patients with no AF, the HRCU was 0.60 ± 1.02 in patients with no DD versus 0.93 ± 1.39 in those with any grade of DD (p < 0.001). Similar findings were seen in patients with AF (HCRU 1.08 ± 1.40 vs. 1.27 ± 1.64, in patients without versus with DD, p < 0.001). At lower grades of DD, the presence of AF is associated with higher HCRU, but this difference dissipates in patients with grade III DD (1.77 ± 2.37 vs. 1.67 ± 2.15, p = 0.42).

Discussion

DD is associated with higher HCRU in patients with or without AF.

Conclusion

DD significantly increases HCRU which is higher in the presence of AF. These data emphasize the real-world impact of DD on HCRU and highlight the need to prioritize DD diagnosis and treatment to improve patients' health and reduce cost.