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The natural history of isolated left ventricular diastolic dysfunction
W C Brogan1, L D Hillis, E D Flores
1Department of Internal Medicine (Cardiovascular Division), University of Texas Southwestern Medical Center, Dallas 75235.
Insights
Isolated left ventricular diastolic dysfunction has low cardiac mortality but significant morbidity, including heart failure symptoms and chest pain hospitalizations.
Area of Science:
- Cardiology
- Internal Medicine
- Heart Failure Research
Background:
- Isolated left ventricular diastolic dysfunction (LVDD) is a condition affecting heart relaxation.
- Understanding the long-term outcomes of LVDD is crucial for patient management.
Purpose of the Study:
- To evaluate the natural history of isolated left ventricular diastolic dysfunction.
- To assess cardiac mortality and morbidity in patients with LVDD.
Main Methods:
- A cohort of 51 patients with isolated LVDD was followed for an average of 68 months.
- Inclusion criteria included elevated left ventricular end-diastolic pressure and normal ejection fraction, volumes, coronary arteries, and valves.
- Data collected included mortality, development of congestive heart failure symptoms, and hospitalizations for chest pain.
Main Results:
- Seven patients died during follow-up, with only one cardiac-related death.
- Among the 44 survivors, 45% developed new-onset congestive heart failure symptoms.
- Twenty-seven percent of patients were hospitalized for recurrent chest pain.
Conclusions:
- Isolated left ventricular diastolic dysfunction is linked to a low risk of cardiac death.
- However, LVDD is associated with considerable morbidity, including heart failure and chest pain.
Study Objective:
To assess the natural history of isolated left ventricular diastolic dysfunction.
Patients And Methods:
Follow-up (average duration, 68 months) was obtained in 51 patients with isolated left ventricular diastolic dysfunction at cardiac catheterization, characterized by (1) an elevated left ventricular end-diastolic pressure; (2) normal left ventricular end-diastolic and end-systolic volumes; (3) normal left ventricular ejection fraction; (4) no coronary artery disease; and (5) no valvular disease.
Results:
During follow-up, seven patients died, but only one died of cardiac causes. Of the 44 living subjects, 20 (45%) noted new-onset symptoms of congestive heart failure, with 11 (25%) of these requiring hospitalization, and 12 (27%) required hospitalization for recurrent chest pain.
Conclusions:
Isolated left ventricular diastolic dysfunction is associated with a low cardiac mortality; at the same time, however, it is associated with substantial morbidity.