© 2004 European Society of Cardiology
Echocardiographic indices of left ventricular diastolic dysfunction in 647 individuals with preserved left ventricular systolic function
a Department of Cardiology and Endocrinology, Frederiksberg University Hospital Nordre Fasanvej 57, DK-2000 Frederiksberg-Copenhagen, Denmark
b Department of Clinical Physiology, Frederiksberg University Hospital Copenhagen, Denmark
c Division of Cardiology, Aker University Hospital Oslo, Norway
* Corresponding author. Tel.: +45-38164350; fax: +45-38164359. E-mail address: frants{at}dadlnet.dk
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Abstract |
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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.
Key Words: Diastolic dysfunction • Heart failure • Echocardiography • Epidemiology
Received January 31, 2003; Revised October 23, 2003; Accepted December 7, 2003
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