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A Three-Year Observational Study of the Prevalence of Left Ventricular Diastolic Dysfunction in Asymptomatic

Milan Mehta1, Nileshkumar Khanpara2

  • 1Cardiology, Sardar Patel Hospital and Heart Institute, Bharuch, IND.

Cureus
|February 2, 2026
PubMed

Insights

Clinically significant left ventricular diastolic dysfunction (LVDD) is uncommon in asymptomatic adults without risk factors. However, its prevalence significantly increases with hypertension, diabetes, and severe obesity, highlighting cardiometabolic contributions.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Echocardiography

Background:

  • Left ventricular diastolic dysfunction (LVDD) can precede heart failure and may be subclinical in asymptomatic individuals.
  • Early identification of LVDD is crucial in populations with cardiometabolic risk factors for risk stratification and prevention.
  • Subclinical LVDD can refine risk assessment and guide preventive strategies in at-risk populations.

Purpose of the Study:

  • To determine the prevalence of clinically significant LVDD (grade II-III) in asymptomatic adults aged 51-70 years.
  • To compare the burden of LVDD across major cardiovascular risk groups, including hypertension, diabetes mellitus, and severe obesity.
  • To investigate the association between cardiometabolic risk factors and the prevalence of diastolic dysfunction.

Main Methods:

  • Retrospective cross-sectional analysis of 5,482 asymptomatic individuals aged 51-70 years from 10,434 transthoracic echocardiograms.
  • Exclusion criteria included symptomatic patients, structural heart disease, low ejection fraction (<50%), arrhythmias, and grade I LVDD.
  • Participants were categorized into healthy controls, isolated hypertension, isolated diabetes mellitus, combined hypertension and diabetes mellitus, and severe obesity (BMI >40 kg/m²). Diastolic function was assessed using Doppler echocardiography.

Main Results:

  • Clinically significant LVDD prevalence was 3.7% in healthy controls.
  • Prevalence increased to 13.1% in hypertension, 10.9% in diabetes mellitus, and 29.1% in combined hypertension and diabetes.
  • The highest prevalence was observed in severe obesity (53.5%), with a stepwise increase across escalating cardiometabolic risk profiles.

Conclusions:

  • Clinically significant LVDD is uncommon in asymptomatic individuals without risk factors but substantially more prevalent in those with hypertension, diabetes, or severe obesity.
  • The findings underscore the significant cardiometabolic contribution to diastolic dysfunction.
  • Targeted evaluation of high-risk groups for LVDD is warranted, though routine screening of all asymptomatic individuals is not supported by this study.
Abstract

Keywords:
asymptomaticdiabetes mellitusdiastolic dysfunctionechocardiographyhypertensionobesityscreening

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