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Asymptomatic Left Ventricular Diastolic Dysfunction: Predicting Progression to Symptomatic Heart Failure

Wojciech Kosmala1, Thomas H Marwick2

  • 1Cardiology Department, Wroclaw Medical University, Wroclaw, Poland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia.

JACC. Cardiovascular Imaging
|April 22, 2019
PubMed

Insights

Asymptomatic left ventricular diastolic dysfunction (ALVDD) predicts future heart failure (HF) and poorer survival. Early detection and management of ALVDD and related conditions can improve patient outcomes.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Medical Diagnostics

Background:

  • Asymptomatic left ventricular diastolic dysfunction (ALVDD) is linked to increased heart failure (HF) risk and reduced survival.
  • ALVDD may represent a preclinical stage (Stage B HF) in individuals predisposed to HF development.

Purpose of the Study:

  • To highlight the significance of ALVDD as a predictor of adverse cardiovascular events.
  • To emphasize the role of imaging in identifying and monitoring preclinical diastolic dysfunction.
  • To discuss factors influencing the progression from ALVDD to symptomatic HF and potential management strategies.

Main Methods:

  • Utilizes echocardiography and other imaging techniques for diagnosis and tracking of preclinical left ventricular (LV) diastolic disturbances.
  • Reviews clinical data and literature concerning cardiovascular and noncardiovascular determinants of ALVDD progression.

Main Results:

  • ALVDD is associated with incident heart failure and decreased survival.
  • Preclinical diastolic abnormalities require advanced imaging for detection and monitoring.
  • Multiple factors contribute to the transition from ALVDD to symptomatic heart failure.

Conclusions:

  • ALVDD signifies an elevated risk for heart failure and warrants consideration in Stage B HF definitions.
  • Proactive management of cardiovascular and systemic comorbidities in ALVDD patients may delay symptomatic progression.
  • Early identification and intervention in ALVDD can potentially improve long-term prognosis and patient survival.

Keywords:
global longitudinal strainheart failure with preserved ejection fractionleft ventricular diastolic dysfunctionstage B heart failure

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