RISK FACTORS OF DIASTOLIC HEART FAILURE

AN EPIDEMIOLOGICAL ANALYTIC STUDY

Abstract

Background and objective: Isolated diastolic
dysfunction /heart failure is the cause of congestive heart failure in 50% of patients with normal systolic function. Several
factors have been shown to be predisposing conditions associated with the development of diastolic dysfunction and
diastolic heart failure. This study was designed to study the common and important factors leading to diastolic
dysfunction of the heart. Study design: This was a descriptive analytic study. Place & Duration: This study was
conducted at Cardiology Department of Mayo Hospital Lahore from January 1998 to September 1998. Material and
methods: One hundred patients of diastolic heart failure who fulfilled our inclusion criteria were studied when they
presented to echo room for echocardiography. Detailed Echocardiography examination of all patients included in this
study was done to measure Doppler parameters of diastolic dysfunction like deceleration time, isovolumic relaxation
time, S & D wave measurements on pulmonary vein. Detailed history was taken and physical examination was
performed to evaluate the risk factor associated with diastolic dysfunction in each patient. Results Mean age of the
study population was 511 18 years. Majority of patients 50(50%) had age range from 36 to 55 years. There were
62(62%) male and 38(38%) female patients. Majority of patients 34(34%) had NYHA class I symptoms and 30(30%)
patients were in NYHA class II. Ejection fraction was normal in 54(54%) of patients while it was less than 40% in 24%
of patients. Majority of patients, 28(28%) had Ischemic heart disease while 24(24%) patients had hypertension and
14(14%) had diabetes mellitus. Hypertension and Ischemic heart disease were present in 14(14%) patients.
Conclusion Approximately 40% - 50% of patients with or without overt clinical features of heart failure have isolated
diastolic dysfunction / DHF with normal systolic function. Coronary artery disease, arterial hypertension and diabetes
mellitus are the major factors associated with diastolic dysfunction and DHF. Obesity and aging also contribute
independently to the development of diastolic dysfunction in a reasonable number of patients.