Diastolic dysfunction progression and development of heart failure

January 01, 0001

Diastolic dysfunction progression and development of heart failure

These US researchers sought to characterize the age dependent changes in diastolic function and their relationship to developing heart failure. They randomly selected patients over age 45 years in the Olmsted County Heart Function Study, forming a population-based cohort. Enrollees initially underwent clinical evaluation, medical record review, and echocardiography (examination 1). Four years later, participants were re- evalutated to return for examination 2. Patients then underwent follow-up to monitor for incident heart failure.

The researchers found: "During the 4 years between examinations 1 and 2, diastolic dysfunction prevalence increased from 23.8% to 39.2%. Diastolic function grade worsened in 23.4% of participants, was unchanged in 67.8%, and improved in 8.8%. Worsened diastolic dysfunction was associated with age 65 years or older (odds ratio, 2.85). During 6.3 years of additional follow-up, heart failure occurred in 2.6%, 7.8%, and 12.2% of persons whose diastolic function normalized or remained normal, remained or progressed to mild dysfunction, or remained or progressed to moderate or severe dysfunction, respectively. Diastolic dysfunction was associated with incident heart failure after adjustment for age, hypertension, diabetes, and coronary artery disease (hazard ratio, 1.81)."

The researchers concluded: "In a population-based cohort undergoing 4 years of follow-up, prevalence of diastolic dysfunction increased. Diastolic dysfunction was associated with development of heart failure during 6 years of subsequent follow-up."

This study helps to characterize age-related changes in diastolic function and its relationship with incident heart failure.

For the full abstract, click here.

JAMA 306(8):856-863, 24 August 2011 © 2011 American Medical Association
Progression of Left Ventricular Diastolic Dysfunction and Risk of Heart Failure. Garvan C. Kane, Barry L. Karon, Douglas W. Mahoney, et al.

Category: K. Circulatory. Keywords: diastolic dysfunction, age, heart failure, progression, echocardiography, prospective cohort study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 9 September 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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