A screening echocardiogram to identify diastolic dysfunction leads to better outcomes

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.