Abstract

Diastolic dysfunction is an entity comes to focus as a contributor to left ventricular dysfunction and should be looked for in the assessment of our patients as it could be the cause for or associated with underlying left ventricular dysfunction hence the definition of heart failure is changed to heart failure with preserved ejection fraction. The process of myocardial remodeling starts before the onset of symptoms of heart failure.
Aim: Assessment of diastolic dysfunction prevalence in patients attending Cardiology clinic with different presentations and risk factors, representing the usual daily practice.
Patients and methods: This is a retrospective record-based cross sectional study, carried out in Consultant Interventional Cardiologist* clinic in Al- Nasiriya, South of Iraq.
Results: Participants were 186, females were 95 (51.1 %) while males were 91 (48.9 %). Median age of the patients was 57 years, mean age was 56.2 +- 12.2. Diastolic dysfunction in different grades was found in 79 patients (42.4%). Diastolic dysfunction was significantly more in patients with Hypertension (53 out of 92 patients) which is (57.6%) with a (P value of 0.0001), and in those with Regional Wall Motion Abnormality (24 out of 40 patients) equals to (70%) with a P value of 0.001, while it was not significantly associated with Diabetes Mellitus. When we took the averaged E/e- as a surrogate to classify Diastolic Dysfunction: grade <14 in grade I, > 14 in grades II & III. An important notice that increased E/e- was also found in patients with no hypertension and no Left ventricular hypertrophy although the number is small & of no statistical significance it raises the question about the possible structural LV changes that lead to the progression of Diastolic Dysfunction to a higher grade.
Conclusion: Diastolic dysfunction is more prevalent with age, yet most of the time is only a grade I (just impaired relaxation). Measurement of diastolic dysfunction via transmitral flow pulse wave Doppler and tissue Doppler imaging of mitral annulus velocities is easy to be performed, adding more diagnostic to echocardiography, therefore; it should be done unless not applicable.