Pre-Clinical Diastolic Dysfunction

Abstract

Preclinical Diastolic Dysfunction (PDD) has been broadly defined as subjects with left ventricular diastolic dysfunction, without the diagnosis of congestive heart failure (HF), and with normal systolic function. PDD is an entity which remains poorly understood, yet has definite clinical significance. Although few original studies have focused on PDD, it has been shown that PDD is prevalent, and that there is a clear progression from PDD to symptomatic heart failure including dyspnea, edema, and fatigue. In diabetic patients and patients with coronary artery disease or hypertension, it has been shown that patients with PDD have a significantly higher risk of progression to heart failure and death compared to patients without PDD. Because of these findings and the increasing prevalence of the heart failure epidemic, it is clear that an understanding of PDD is essential to decreasing patients’ morbidity and mortality. This review will focus on what is known concerning preclinical diastolic dysfunction, including definitions, staging, epidemiology, pathophysiology, and the natural history of the disease. In addition, given the paucity of trials focused on PDD treatment, studies targeting risk factors associated with the development of PDD and therapeutic trials for heart failure with preserved ejection fraction will be reviewed.

Renin overexpression leads to increased titin-based stiffness contributing to diastolic dysfunction in hypertensive mRen2 rats

“…These rats apparently adapt to the increased ventricular stiffness by thickening of the atrial wall (LA hypertrophy) and by increasing late LV filling velocity (increased A wave) and pressure gradient. Hence, our observations in this experimental model might contribute to greater understanding of the mechanism of preclinical diastolic dysfunction, a great importance in human (42). We have investigated the molecular mechanisms leading to diastolic dysfunction in the mRen2 animal model.…”

Screening echocardiograms in a senior focused value based primary care improves systolic heart failure detection and clinical management

“…EF less than 50% was used as a cutoff for abnormal LVEF (LV systolic dysfunction). Diastolic function was classified according to recent recommendations of ASE on diastolic functional evaluation (9). The grading scheme was mild or grade I (impaired relaxation pattern), moderate or grade II (pseudonormalized filling), and severe (restrictive pattern) or grade III (9).…”

Exercise Training in Group 2 Pulmonary Hypertension: Which Intensity and What Modality

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