Diastolic Dysfunction and Risk of Heart Failure

Left ventricular diastolic dysfunction is highly prevalent, tends to worsen over time, and is associated with advancing age. Worsening diastolic function can be detected even in apparently healthy persons, the conclusion by the authors of a recent article published in JAMA.

Randomly selected participants 45 years or older (N = 2042) underwent clinical evaluation, medical record abstraction, and echocardiography (examination 1 [1997-2000]). Diastolic left ventricular function was graded as normal, mild, moderate, or severe by validated Doppler techniques. After 4 years, participants were invited to return for examination 2 (2001-2004). The cohort of participants returning for examination 2 (n = 1402 of 1960 surviving [72%]) then underwent follow-up for ascertainment of new-onset heart failure (2004-2010).

During the 4 years between examinations, diastolic dysfunction prevalence increased from 23.8% to 39.2%:

Age was predictive of the development of diastolic dysfunction, especially ages 65 years or older (odds ratio [OR], 2.85 [1.77-4.72]), as well as Hypertension (OR 1.93 [1.45-2.57]):

(From: Progression of Left Ventricular Diastolic Dysfunction and Risk of Heart Failure, Garvan C. Kane, MD, PhD et al. JAMA. 2011;306(8):856-863)