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A screening echocardiogram to identify diastolic dysfunction leads to better outcomes

Reyan Ghany1, Ana Palacio2,3, Gordon Chen1

  • 1Chen Senior Medical Centers, Miami, FL, USA.

Echocardiography (Mount Kisco, N.Y.)
|July 4, 2017
PubMed

Insights

Screening echocardiograms found moderate-to-severe diastolic dysfunction (DD) in 27% of seniors. Identifying DD in older adults improves heart failure care and medication management.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Diagnostic Imaging

Background:

  • Diastolic dysfunction (DD) is a precursor to heart failure and increased mortality.
  • Echocardiography detects DD but is not routinely recommended for screening in older adults.
  • This study evaluated the prevalence and clinical impact of DD screening in seniors.

Purpose of the Study:

  • To determine the prevalence of diastolic dysfunction in an elderly population.
  • To assess the impact of identifying DD on heart failure management in seniors.
  • To evaluate the effectiveness of screening echocardiograms in value-based senior care settings.

Main Methods:

  • A screening echocardiogram was performed on 5227 consecutive patients across 36 senior-focused clinics.
  • Diastolic dysfunction was graded, and patients were classified as asymptomatic (Stage B) or symptomatic (Stage C).
  • Changes in heart failure medication prescriptions before and after echocardiography were analyzed.

Main Results:

  • The prevalence of moderate-to-severe DD (Grade 2-3) with preserved ejection fraction was 25%.
  • Among patients with moderate-to-severe DD, 27% were symptomatic (Stage C).
  • Prescription of ace-inhibitors, beta-blockers, statins, and diuretics increased post-echocardiogram, particularly in symptomatic DD patients.

Conclusions:

  • A significant portion of seniors without prior heart failure diagnosis exhibit moderate-to-severe diastolic dysfunction.
  • Screening for DD in older adults can lead to improved heart failure therapy and patient care.
  • Early identification of DD in seniors is crucial for proactive management and better health outcomes.
Abstract

Keywords:
diastolic dysfunctionechocardiographyelderly

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