Prevalence of diastolic dysfunction as a possible cause of dyspnea in the elderly.
OBJECTIVE
Symptoms in patients with heart failure and preserved left ventricular ejection fraction may be caused by isolated diastolic dysfunction. The purpose of this study was to assess the prevalence of diastolic dysfunction as a potential cause of dyspnea in a sample of elderly subjects, as well as of isolated diastolic dysfunction as a potential cause of dyspnea in a subgroup with a preserved left ventricular ejection fraction and normal lung function.


METHODS
A total of 152 subjects with dyspnea underwent echocardiography, electrocardiography, and lung function testing. Subjects with normal lung function test results (n = 60) underwent cardiac magnetic resonance imaging, chest radiography, bicycle exercise tests, and blood tests. Left ventricular diastolic function was assessed by a variety of echocardiographic/Doppler techniques.


RESULTS
Of 129 subjects with dyspnea, 81 (63%) had signs of lung disease or 'obvious' cardiac disease. In the remaining 48 subjects, 32 (67%) had a potential cardiac/noncardiac cause of dyspnea. In all subjects with dyspnea, 1% to 11% had diastolic dysfunction, and in the 48 remaining subjects, 0% to 10% had isolated diastolic dysfunction, depending on the definition used.


CONCLUSIONS
The frequency of diastolic dysfunction was low in the sample of elderly subjects with dyspnea as well as in the subgroup of persons with no signs of lung disease, left ventricular systolic dysfunction, atrial fibrillation, or valvular heart disease. Diastolic dysfunction was infrequent as a possible cause of dyspnea, and coexisting potential causes of dyspnea were often present.
Pedersen
Frants
F
Frederiksberg University Hospital, Department of Cardiology and Endocrinology, Nordre Fasanvej 57, DK-2000 Frederiksberg-Copenhagen, Denmark. frants@dadlnet.uk
Raymond
Ilan
I
Mehlsen
Jesper
J
Atar
Dan
D
Hildebrandt
Per R
PR
D000368:Aged; D003937:Diagnosis, Differential; D003971:Diastole; D004417:Dyspnea / Q000209:etiology*; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009664:Norway / Q000453:epidemiology; D015995:Prevalence; D012129:Respiratory Function Tests; D013318:Stroke Volume; D018754:Ventricular Dysfunction / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis