Diastolic Dysfunction

Graded by echocardiography as mild, moderate or severe

Increase in pressure load or impaired relaxation ability of the heart can cause heart failure.

Occurs more frequent in women and in patients with hypertension and diabetes.

Severe dysfunction associated with increase risk of mortality in conditions such as: post-myocardial infarction, amyloidosis, hypertension, chronic renal insufficiency, with systolic dysfunction and with normal systolic function.

In a study of outpatients undergoing echocardiogram sudies with normal systolic dysfunction 65.2% of patients had DD, most cases being mild (Halley GM et al).

In the above study only moderate to severe disease was associated with increased mortality risk.

Associated with dyspnea.

DD is a continuum from mild asymptomatic to severe and symptomatic.

Prevaence among studied populations and in the community setting may be as high as 28%.

Incidence of CHF and symptoms occur at a rate of 31% during two years follow-up (Redfield MM et al).

Echocardiogram results for mild diastloc dysfunction is typified by abnormal myocardial relaxation with normal left atrial pressures-grade I.

Echocardiogram grade II findings of moderate diastolic dysfnction indicates a pseudonormal pattern, while grade III shows a restrictive pattern.

Echocardiogram findings in moderate and severe diastolic dysfunction increases in the mean left atrial pressures occur in addition to the impairment of left ventricular relaxation and compliance.

The rate of progression to clinical heart failure in patients with normal systolic function and moderate or severe diastolic dysfunction is low at two years, although there was a moderate rate of progression to the development of symptoms and hospitalizations (Correa de Sa DD et al).

Olmsted County Heart Function Study the following individuals 45 years or older who were evaluated for the presence of diastolic left and check in the function, and after four years of follow-up diastolic dysfunction prevalence increased from 23.8% to 39.2% and diastolic function grade worsened in 23.4%: diastolic dysfunction was associated with the incident heart failure in subsequent follow-up (Kane GC et al).

Longitudinal evaluation reveals that left ventricular diastolic dysfunction is highly prevalent, worsens with time and is associated with advancing age.

Persistence or progression of diastolic dysfunction is a risk factor for heart failure in elderly persons.

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