Article Text

other Versions

Evolution and Outcome of Diastolic Dysfunction
  1. Naomi Achong
  1. University of Queensland, Australia
    1. Sudhir Wahi
    1. University of Queensland, Australia
      1. Thomas H Marwick (t.marwick{at}
      1. University of Queensland, Australia


        Background: Diastolic dysfunction (DD) is highly prevalent and associated with increased morbidity and mortality, but its natural history remains poorly defined.

        Objective: This cohort study sought to characterize the influence of clinical features, medical therapy and echocardiographic parameters on the progression of DD.

        Methods: We identified 926 consecutive patients (62 ± 14 years, 221 women) with DD and preserved systolic function. A repeat echocardiogram was performed in 199 patients >1 year after the baseline study (average 3.6±1.4 years). Follow-up for 4.8±2.5 years was 97% complete for the major endpoint of all-cause mortality. Cox regression analyses were performed to identify the associations of mortality.

        Results: Over follow-up, 142 patients died and 22 were admitted with heart failure. The independent predictors of death were age, hyperlipidaemia, co-morbid disease and restrictive filling. The degree of diastolic dysfunction remained stable in 52%, deteriorated in 27% and improved in 21%. There was a greater use of medical therapy in those with stable or worsening diastolic function; when the protective effects of these agents were taken into account in a multivariate model, improvement in diastolic dysfunction was associated with a survival benefit.

        Conclusion: DD is associated with all-cause mortality, independent of the presence of a major co-morbidity. The degree of DD remains stable in about 50% of patients, the population whose diastolic function improves over time has a more favourable outcome.

        Statistics from

        Request permissions

        If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.