Key result
Preclinical diastolic dysfunction is common and independently linked to higher risks of heart failure and mortality.
Why the study?
Preclinical diastolic dysfunction remains poorly understood and few original studies have focused on it, despite its clear progression to symptomatic heart failure and increased risk of death.
Answers are grounded in this paper and cite their sources.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Does DD exist that does not progress to HF? If the physician identifies DD in a patient with mild or no symptoms, will that patient progress to frank heart failure and have a higher mortality risk?”
Recognizing preclinical diastolic dysfunction is clinically crucial for early intervention, as it is a prevalent and high-risk precursor to symptomatic heart failure with preserved ejection fraction.
Preclinical Diastolic Dysfunction (PDD) has been broadly defined as subjects with left ventricular diastolic dysfunction, without the diagnosis of congestive heart failure (HF), and with normal systolic function. PDD is an entity which remains poorly understood, yet has definite clinical significance. Although few original studies have focused on PDD, it has been shown that PDD is prevalent, and that there is a clear progression from PDD to symptomatic heart failure including dyspnea, edema, and fatigue. In diabetic patients and patients with coronary artery disease or hypertension, it has been shown that patients with PDD have a significantly higher risk of progression to heart failure and death compared to patients without PDD. Because of these findings and the increasing prevalence of the heart failure epidemic, it is clear that an understanding of PDD is essential to decreasing patients’ morbidity and mortality. This review will focus on what is known concerning preclinical diastolic dysfunction, including definitions, staging, epidemiology, pathophysiology, and the natural history of the disease. In addition, given the paucity of trials focused on PDD treatment, studies targeting risk factors associated with the development of PDD and therapeutic trials for heart failure with preserved ejection fraction will be reviewed.
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Wan et al. (2013) conducted a review in Preclinical Diastolic Dysfunction (PDD). Preclinical Diastolic Dysfunction was evaluated. Preclinical diastolic dysfunction is highly prevalent in the general adult population and is independently associated with an increased risk of progression to symptomatic heart failure and mortality.
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