Characteristics of left ventricular diastolic dysfunction in the community: an echocardiographic survey.
OBJECTIVE
To determine the prevalence and predictors of left ventricular (LV) diastolic dysfunction in older adults.


METHODS
A cross-sectional survey of 1275 randomly selected residents of Canberra, aged 60 to 86 years (mean age 69.4; 50% men), conducted between February 2002 and June 2003.


METHODS
Prevalence of LV diastolic dysfunction as characterised by comprehensive Doppler echocardiography.


RESULTS
The prevalence of any diastolic dysfunction was 34.7% (95% CI 32.1% to 37.4%) and that of moderate to severe diastolic dysfunction was 7.3% (95% CI 5.9% to 8.9%). Of subjects with moderate to severe diastolic dysfunction, 77.4% had an LV ejection fraction (EF) > 50% and 76.3% were in a preclinical stage of disease. Predictors of diastolic dysfunction were higher age (p < 0.0001), reduced EF (p < 0.0001), obesity (p < 0.0001) and a history of hypertension (p < 0.0001), diabetes (p = 0.02) and myocardial infarction (p = 0.003). Moderate to severe diastolic dysfunction with normal EF, although predominantly preclinical, was independently associated with increased LV mass (p < 0.0001), left atrial volume (p < 0.0001), and circulating amino-terminal pro-B-type natriuretic peptide concentrations (p < 0.0001), and with decreased quality of life (p < 0.005).


CONCLUSIONS
Diastolic dysfunction is common in the community and often unaccompanied by overt congestive heart failure. Despite the lack of symptoms, advanced diastolic dysfunction with normal EF is associated with reduced quality of life and structural abnormalities that reflect increased cardiovascular risk.
National Centre for Epidemiology and Population Health, Australian National University and Department of Cardiology, The Canberra Hospital, Canberra, ACT, Australia. abhayaratna.walter@mayo.edu
W P
WP
Abhayaratna
T H
TH
Marwick
W T
WT
Smith
N G
NG
Becker
D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology