Diastolic dysfunction natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Heart failure associated with diastolic dysfunction has a slightly better prognosis than that of systolic heart failure. However, the presence or absence of coronary artery disease, the age, and the left ventricular ejection fraction cut off level must all be taken into consideration in stratifying patients and assessing their prognosis.[1]
Prognosis
- Until recently, it was generally assumed that the prognosis for individuals with diastolic dysfunction and associated intermittent pulmonary edema was better than those with systolic dysfunction. In fact, in two studies appearing in the New England Journal of Medicine in 2006, evidence was presented to suggest that the prognosis in diastolic dysfunction is the same as that in systolic dysfunction.[2][3]
- Other studies have shown that the prognosis of diastolic heart failure is slightly better than that of systolic heart failure. In general, the annual mortality associated with diastolic heart failure was estimated to be 5 to 8 % compared to an estimated annual mortality of 10 to 15% in systolic heart failure and an annual mortality of 1% in the general population. However, the 3 to 5% annual mortality from diastolic heart failure was estimated without any adjustment for the presence or absence of coronary artery disease, age and the cut off value of left ventricular ejection fraction used for the diagnosis of diastolic heart failure. Hence, if patients with coronary artery disease have been excluded, the annual mortality of patients with diastolic heart failure drops to 2-3%. If the age is taken into account, patients who are 70 years of age and have diastolic heart failure are estimated to have a similar annual mortality rate to that of patients within the same age range and having systolic heart failure. [1]
References
- ↑ 1.0 1.1 Terek RM, Wehner J, Lubicky JP (1991). "Crankshaft phenomenon in congenital scoliosis: a preliminary report". J Pediatr Orthop. 11 (4): 527–32. PMID 1860957.
- ↑ Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM (2006). "Trends in prevalence and outcome of heart failure with preserved ejection fraction". N Engl J Med. 355 (3): 251–9. doi:10.1056/NEJMoa052256. PMID 16855265.
- ↑ Bhatia RS, Tu JV, Lee DS, Austin PC, Fang J, Haouzi A; et al. (2006). "Outcome of heart failure with preserved ejection fraction in a population-based study". N Engl J Med. 355 (3): 260–9. doi:10.1056/NEJMoa051530. PMID 16855266. Review in: Evid Based Med. 2006 Dec;11(6):185 Review in: ACP J Club. 2006 Nov-Dec;145(3):78
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