RISK FACTORS OF DIASTOLIC HEART FAILURE

Background and objective: Isolated diastolicdysfunction /heart failure is the cause of congestive heart failure in 50% of patients with normal systolic function. Severalfactors have been shown to be predisposing conditions associated with the development of diastolic dysfunction anddiastolic heart failure. This study was designed to study the common and important factors leading to diastolicdysfunction of the heart. Study design: This was a descriptive analytic study. Place & Duration: This study wasconducted at Cardiology Department of Mayo Hospital Lahore from January 1998 to September 1998. Material andmethods: One hundred patients of diastolic heart failure who fulfilled our inclusion criteria were studied when theypresented to echo room for echocardiography. Detailed Echocardiography examination of all patients included in thisstudy was done to measure Doppler parameters of diastolic dysfunction like deceleration time, isovolumic relaxationtime, S & D wave measurements on pulmonary vein. Detailed history was taken and physical examination wasperformed to evaluate the risk factor associated with diastolic dysfunction in each patient. Results Mean age of thestudy population was 511 18 years. Majority of patients 50(50%) had age range from 36 to 55 years. There were62(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 and14(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 isolateddiastolic dysfunction / DHF with normal systolic function. Coronary artery disease, arterial hypertension and diabetesmellitus are the major factors associated with diastolic dysfunction and DHF. Obesity and aging also contributeindependently to the development of diastolic dysfunction in a reasonable number of patients.