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Related Concept Videos

Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

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The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
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Updated: Jun 1, 2025

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Association of Impaired Relaxation Mitral Inflow Pattern (Grade 1 Diastolic Function) With Long-Term

Kathleen A Young1, Richard J Rodeheffer1, Jared G Bird1

  • 1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|January 17, 2025
PubMed
Summary

Abnormal left ventricular diastolic function, specifically an impaired relaxation pattern, is common in older adults and predicts increased risk of death, including cardiovascular and dementia-related causes.

Keywords:
Diastolic dysfunctionDiastolic functionImpaired myocardial relaxationMortality outcomes

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Area of Science:

  • Cardiology
  • Echocardiography
  • Geriatric Medicine

Background:

  • Left ventricular diastolic dysfunction is a known predictor of heart failure and mortality.
  • The study aimed to differentiate the drivers of mortality associated with diastolic dysfunction.
  • It investigated impaired relaxation mitral inflow patterns as a potential risk marker.

Purpose of the Study:

  • To determine if cardiovascular or noncardiovascular death drives the association between diastolic function and mortality.
  • To assess if an impaired relaxation mitral inflow pattern is a significant risk marker.

Main Methods:

  • Utilized the Mayo Clinic algorithm for diastolic function grading on a prospective cohort.
  • Excluded patients with reduced ejection fraction, significant valve disease, heart failure diagnosis, or indeterminate diastolic function.
  • Classified patients with impaired relaxation (E/A ratio < 0.8) as grade 1, irrespective of other factors.

Main Results:

  • Grade 1 diastolic function was prevalent (26%) in 1,005 community-dwelling older adults.
  • Grade 1 diastolic function was strongly associated with all-cause mortality (HR 4.05).
  • This association persisted in those with isolated impaired relaxation (HR 2.71) and was linked to cardiovascular mortality (HR 2.43) and dementia death risk (HR 2.30).

Conclusions:

  • An impaired relaxation mitral inflow pattern (grade 1) is a common finding in older adults.
  • This echocardiographic finding is associated with cause-specific mortality, including cardiovascular and dementia-related deaths.
  • It serves as a potential biomarker for cardiovascular and cognitive risk, not a benign age-related change.