Preclinical diastolic dysfunction is a prevalent condition associated with a significantly higher risk of progression to symptomatic heart failure and death, though specific treatment trials are lacking.
This review highlights the clinical significance of Preclinical Diastolic Dysfunction as a prevalent condition with a high risk of progression to symptomatic heart failure, emphasizing the need for better understanding and targeted treatments.
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.
“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?”
Wan et al. (Wed,) conducted a review in Preclinical Diastolic Dysfunction. Preclinical diastolic dysfunction is a prevalent condition associated with a significantly higher risk of progression to symptomatic heart failure and death, though specific treatment trials are lacking.