Prevalence of Diastolic Dysfunction in an Asymptomatic Young and Middle Aged Individuals Attending a Tertiary Care Hospital

ABSTRACT

Left ventricular (LV) diastolic dysfunction is increasingly recognized as an important cause of heart failure, providing prognostic information that is incremental to systolic function. Symptomatic DD can occur in association to left ventricular (LV) systolic dysfunction or be a determinant of heart failure with preserved systolic function (ejection fraction >50%), which is responsible for 51% of the heart failure cases. We sought to examine the relationship between atrial volume indexed to body surface area (LAVi) and clinical and Doppler echocardiographic parameters in randomly selected participants. Methods: The Present study included 1021 subjects of both gender. Two-dimensional and color Doppler imaging were performed to screen for valvular stenosis or regurgitation. Diastolic function was graded as normal, abnormal relaxation (Grade I), pseudonormal (Grade II), and restrictive (Grade III). Results: Mean LAVi and the prevalence of LA enlargement increase with worsening diastolic function grade. Distribution of diastolic function and the associated mean LAVi. Atrial size, as measured by LAVi, increases progressively with increasing DD (r <0.20; p<0.01). The prevalence of LA enlargement also increases with increasing severity of DD. After controlling for age, gender, EF, and LAVi, diastolic function grade was associated with all-cause mortality. Adjusting for age, gender, EF, and diastolic function grade, LAVi was not associated with all-cause mortality. Conclusion: This study in Indian population suggests that DD contributes to left atrial remodeling and LAVI increase is an expression of DD severity. LAVI increase determinants in this sample with preserved or slightly reduced mean ejection fraction and no significant valvular heart disease are partly related to age, left ventricular hypertrophy, increased filling pressure and decreased LV systolic function