Diastolic Dysfunction Ups Heart Failure Risk in Elderly

Diastolic dysfunction is prevalent, worsens over time, and is associated with increasing age

WEDNESDAY, Aug. 24 (HealthDay News) -- Left ventricular diastolic dysfunction worsens over time and with advancing age, increasing the risk of subsequent heart failure, according to a study published in the Aug. 24/31 issue of the Journal of the American Medical Association.

Garvan C. Kane, M.D., Ph.D., from the Mayo Clinic and Medical School in Rochester, Minn., and colleagues investigated changes in diastolic function over time, and assessed the relationship between diastolic dysfunction and the risk of heart failure in 2,042 patients aged 45 years or older. Examination (1997 to 2000) included clinical evaluation, medical record abstraction, and echocardiography, and diastolic left ventricular function was graded as normal, mild, moderate, or severe. After four years, 1,402 participants returned for examination 2 (2001 to 2004) and were followed up for new-onset heart failure (2004 to 2010). Changes in diastolic function grade and incident heart failure were the outcomes measured.

The investigators found that between the time of examinations 1 and 2, the prevalence of diastolic dysfunction increased significantly from 23.8 to 39.2 percent. For 23.4 percent of the patients diastolic function grade worsened, for 67.8 percent it was unchanged, and for 8.8 percent it improved. Worse diastolic function was correlated with being ≥ 65 years of age (odds ratio, 2.85). During follow-up after examination 2, heart failure incidence was seen in 2.6 percent of the patients whose diastolic function was normal, 7.8 percent in those who had mild dysfunction, and 12.2 percent in those with moderate or severe dysfunction. After adjustment for age, hypertension, diabetes, and coronary artery disease, diastolic dysfunction was correlated with incident heart failure (hazard ratio, 1.81).

"Left ventricular diastolic dysfunction is highly prevalent, tends to worsen over time, and is associated with advancing age," the authors write.

Full Text (subscription or payment may be required)

Copyright © 2011 HealthDay. All rights reserved.

Powered by