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Pre-clinical diastolic dysfunction.

Siu-Hin Wan1, Mark W Vogel2, Horng H Chen3

  • 1Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota.

Journal of the American College of Cardiology
|December 3, 2013
PubMed
Summary

Pre-clinical diastolic dysfunction (PDD) is common and can progress to heart failure. Understanding PDD is crucial for reducing patient mortality and morbidity.

Keywords:
B-type natriuretic peptideBNPCOPDDDEFHFHFpEFHFrEFLVLVHN-terminal pro–B-type natriuretic peptideNT-proBNPPDDSDchronic obstructive pulmonary diseasediastolic dysfunctionechocardiographyejection fractionheart failureheart failure epidemiologyheart failure treatmentheart failure with preserved ejection fractionheart failure with reduced ejection fractionleft ventricularleft ventricular hypertrophypre-clinical diastolic dysfunctionsystolic dysfunction

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Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Pre-clinical diastolic dysfunction (PDD) is defined as left ventricular diastolic dysfunction without diagnosed congestive heart failure (HF) and with normal systolic function.
  • PDD is prevalent and associated with a higher risk of progression to symptomatic HF, particularly in patients with diabetes, coronary artery disease, or hypertension.

Purpose of the Study:

  • To review current knowledge on pre-clinical diastolic dysfunction (PDD).
  • To explore definitions, staging, epidemiology, pathophysiology, and natural history of PDD.
  • To examine risk factors and therapeutic trials for HF with preserved ejection fraction (HFpEF) due to limited PDD treatment studies.

Main Methods:

  • Literature review of studies on pre-clinical diastolic dysfunction.
  • Analysis of epidemiological data and risk factors.
  • Review of therapeutic trials for HFpEF.

Main Results:

  • PDD is a prevalent condition with a clear progression to symptomatic heart failure.
  • Patients with PDD face a significantly higher risk of progressing to heart failure and death compared to those without PDD.
  • There is a paucity of treatment trials specifically targeting PDD.

Conclusions:

  • Understanding PDD is essential for reducing morbidity and mortality associated with the heart failure epidemic.
  • Further research into PDD treatment strategies is warranted.
  • Focusing on risk factors and exploring HFpEF treatments may offer therapeutic avenues for PDD.