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LV diastolic dysfunction linked to increased risk for HF

Kane G. JAMA. 2011;306:856-863.

Issue: October 2011

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Progression of left ventricle diastolic dysfunction is highly prevalent, tends to worsen over time and is associated with advancing age and HF, according to a study.

Researchers randomly selected 2,042 participants aged at least 45 years for the Olmsted County Heart Function Study. In the study, participants went through two examinations in 6 years. In the first examination, participants had a physical examination, echocardiography and medical record abstraction before their diastolic LV function was graded as normal, mild, moderate or severe. Four years after the first examination, 1,402 participants returned for the second examination in which all data collected from examination I were recollected. Researchers compared characteristics of examination I participants who returned for examination II with the characteristics of participants who did not.

Researchers found that diastolic dysfunction prevalence increased from 23.8% to 39.2% during the 4 years between the two examinations. According to the study, “Diastolic function grade worsened in 23.4% of participants, was unchanged in 67.8%, and improved in 8.8%.” In examination I, 531 participants did not have hypertension, diabetes, CAD, HF or use of CV medications. Between examinations I and II, there was an increase in prevalence of comorbid conditions, with hypertension increasing from 25.8% to 42.4%, diabetes from 6.3% to 10.3%, and HF from 1.1% to 2.2%.

Of the 2,042 participants in examination I, 82 died before examination II. Eighty-one participants developed HF during 6.3 years of follow-up, with the most potent predictor being old age. Survivors from examination I who did not return for examination II had a higher prevalence of comorbid conditions at examination I, and so diastolic dysfunction was more prevalent. Participants who returned for examination II had a higher survival rate than those who did not.

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