Author + information
- Received January 28, 2019
- Revision received October 9, 2019
- Accepted October 16, 2019
- Published online January 6, 2020.
- Michael Chetrit, MD,
- Paul C. Cremer, MD and
- Allan L. Klein, MD∗ ()
- ↵∗Address for correspondence:
Dr. Allan L. Klein, Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Desk J1-5, Cleveland, Ohio 44195.
• Epidemiological studies provide insight into the natural history, risk factors, and pathophysiology of diastolic dysfunction.
• Key prognostic parameters are left atrial volume index and E/e′, which are feasible and reliably assessed.
• Hypertension, diabetes, and obesity are consistently associated with diastolic dysfunction.
By assessing nonhospitalized asymptomatic patients, community-based studies inform the prevalence, key clinical characteristics, and outcomes associated with diastolic dysfunction. As the number of parameters to define and grade diastolic function continues to increase, there has been a shift to a focus on readily obtainable measurements with minimal interobserver variability. In this regard, mitral inflow and annular tissue Doppler velocities, as well as measurement of left atrial volume index, are the most feasible and reproducible. Within communities, variations in definitions have limited generalizability regarding the prevalence and risks associated with diastolic dysfunction. Nevertheless, community-based studies have established important associations with hypertension, obesity, and diabetes. Randomized controlled trials of treatment in heart failure with preserved ejection fraction have been disappointing. Importantly, diastolic dysfunction is consistently associated with higher mortality, which emphasizes the importance of early recognition and initiation of appropriate preventative treatments.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose. Sherif Nagueh, MD, served as Guest Editor for this paper.
- Received January 28, 2019.
- Revision received October 9, 2019.
- Accepted October 16, 2019.
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