Hindawi Publishing Corporation Cardiology Research and Practice Volume 2012, Article ID 243735, 8 pages doi:10.1155/2012/243735 Research Article Prognostic Value of Left Ventricular Diastolic Dysfunction in Patients Undergoing Cardiac Catheterization for Coronary Artery Disease Hidekatsu Fukuta, Nobuyuki Ohte, Kazuaki Wakami, Toshihiko Goto, Tomomitsu Tani, and Genjiro Kimura Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi Mizuho-Cho Mizuho-Ku, Nagoya 467-8601, Japan Correspondence should be addressed to Hidekatsu Fukuta, fukuta-h@med.nagoya-cu.ac.jp Received 8 December 2011; Accepted 9 February 2012 Academic Editor: Javed Butler Copyright © 2012 Hidekatsu Fukuta et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. We hypothesized that left ventricular (LV) diastolic dysfunction assessed by cardiac catheterization may be associated with increased risk for cardiovascular events. To test the hypothesis, we assessed diastolic function by cardiac catheterization (relaxation time constant (Tau) and end-diastolic pressure (EDP)) as well as Doppler echocardiography (early diastolic mitral annular velocity (e ) and a ratio of early diastolic mitral inﬂow to annular velocities (E/e )) in 222 consecutive patients undergoing cardiac catheterization for coronary artery disease (CAD). During a followup of 1364 ± 628 days, 5 cardiac deaths and 20 unscheduled cardiovascular hospitalizations were observed. Among LV diastolic function indices, Tau > 48 ms and e < 5.8 cm/s were each signiﬁcantly associated with lower rate of survival free of cardiovascular hospitalization. Even after adjustment for potential confounders (traditional cardiovascular risk factors, the severity of CAD, and cardiovascular medications), the predictive value of Tau > 48 ms and e < 5.8 cm/s remained signiﬁcant. No predictive value was observed in EDP, E/e , or LV ejection fraction. In conclusion, LV diastolic dysfunction, particularly impaired LV relaxation assessed by both cardiac catheterization and Doppler echocardiography, is independently associated with increased risk for cardiac death or cardiovascular hospitalization in patients with known or suspected CAD. 1. Introduction Left ventricular (LV) diastolic dysfunction refers to abnor- malities in relaxation, ﬁlling, and distensibility [1]. Evidence of LV diastolic dysfunction can be determined by cardiac catheterization [1]. The presence of LV diastolic dysfunction can also be estimated by Doppler echocardiography [2, 3]. Although studies have shown that LV diastolic abnormalities assessed by Doppler echocardiography are predictive of ad- verse prognosis in various cardiac patients [4–10], the pre- dictive value of invasively-determined diastolic dysfunction is unclear. In the present study, we hypothesized that in- vasively-determined diastolic dysfunction may be associated with increased risk for cardiovascular events. To test the hypothesis, we examined the association of LV diastolic dysfunction assessed by cardiac catheterization as well as Doppler echocardiography with subsequent cardiovascular events in patients undergoing cardiac catheterization for assessment of coronary artery disease (CAD). 2. Methods 2.1. Patients. We studied 222 consecutive Japanese patients who underwent cardiac catheterization for the evaluation of CAD between January 2004 and August 2006. All the patients had symptoms suggestive of angina and/or clinical signs of CAD (positive exercise electrocardiogram and/or abnormal myocardial perfusion scintigram). No patients with acute coronary syndrome, congestive heart failure, atrial ﬁbrillation, primary valvular diseases, idiopathic dilated or