Echocardiographic indices of left ventricular diastolic dysfunction in 647 individuals with preserved left ventricular systolic function

Eur J Heart Fail. 2004 Jun;6(4):439-47. doi: 10.1016/j.ejheart.2003.12.003.

Abstract

Background: Knowledge about the occurrence of isolated diastolic dysfunction (DD) in the general population is limited.

Aims: This population study was performed to assess the frequency and distribution pattern of echocardiographic indices of left ventricular (LV) DD in an elderly population aged 50-89 years in which LV systolic function is preserved.

Methods and results: The study population (n=764) recruited from the background population answered a heart failure questionnaire and underwent echocardiography. Excluding subjects with a LV ejection fraction <50% or atrial fibrillation, diastolic function was evaluated in 647 subjects. The frequency of impaired relaxation according to earlier guidelines was 0.5%, vs. 2.5% using age- and gender-specific normal values of 'E/A-ratio' and 'deceleration time'. In a subpopulation of 167 participants, 6.6% had 'pseudonormalisation'. No difference was found in the frequency of dyspnea in subjects with impaired relaxation or 'pseudonormalisation' compared to subjects with normal filling pattern.

Conclusion: The prevalence of LV impaired relaxation was highly dependent on the choice of normal (cut-off) values for Doppler indices. Furthermore, our findings suggest that either isolated DD is often asymptomatic, or that Doppler flow derived parameters as a diagnostic method for assessing DD have a low specificity when used as a screening tool in the general population.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Denmark / epidemiology
  • Diastole / physiology
  • Echocardiography*
  • Female
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Myocardial Contraction / physiology
  • Observer Variation
  • Prevalence
  • Reproducibility of Results
  • Stroke Volume / physiology
  • Systole / physiology
  • Vasodilation / physiology
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / epidemiology
  • Ventricular Dysfunction, Left / physiopathology*