From the Guidelines
A cardiac echo showing a normal ejection fraction of 60% with grade one diastolic dysfunction indicates that your heart pumps blood normally but has mild difficulty relaxing and filling with blood between beats, and management typically involves controlling risk factors like hypertension and diabetes, and maintaining a heart-healthy lifestyle with regular exercise and a balanced diet 1. The ejection fraction of 60% indicates your heart's pumping function (systolic function) is healthy, as normal range is typically 50-70% 1. Grade one diastolic dysfunction, also called impaired relaxation, is the mildest form of diastolic dysfunction where the heart muscle has become slightly stiff, requiring higher pressures to fill properly. This condition is common with aging and often causes no symptoms. Key points to consider in managing this condition include:
- Controlling risk factors like hypertension and diabetes
- Maintaining a heart-healthy lifestyle with regular exercise and a balanced diet
- Regular follow-up with your cardiologist to monitor for any progression
- Medications are usually not needed specifically for grade one diastolic dysfunction unless you have other cardiac conditions 1. It's also important to note that the diagnosis of diastolic dysfunction can be challenging, and a comprehensive evaluation of clinical presentation, 2D and color Doppler echocardiographic findings, and cardiac structural and functional information should be performed to aid in the assessment of LV diastolic function 1. Overall, this combination of findings suggests your heart can effectively pump blood to your body while having only minor issues with the filling phase of the cardiac cycle.
From the Research
Explanation of Cardiac Echo Results
- A cardiac echo showing a normal ejection fraction of 60% with a grade one diastolic dysfunction indicates that the heart's ability to pump blood is normal, but there is some stiffness in the heart's ventricles, making it harder for them to fill with blood between beats 2.
- Diastolic dysfunction is a condition where the heart's ventricles do not relax properly, leading to increased pressure inside the heart and potentially causing symptoms such as shortness of breath and fatigue.
- Grade one diastolic dysfunction is considered mild, and it may not cause significant symptoms, but it can still be a precursor to more severe heart failure if left untreated.
Diagnostic Criteria for Diastolic Heart Failure
- The diagnosis of diastolic heart failure requires the presence of signs or symptoms of heart failure, normal or mildly abnormal systolic left ventricular function, and evidence of diastolic left ventricular dysfunction 2.
- Diagnostic evidence of diastolic left ventricular dysfunction can be obtained invasively or non-invasively using techniques such as tissue Doppler imaging or blood flow Doppler of the mitral valve or pulmonary veins.
- The E/E' ratio, which is a measure of the ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity, can be used to diagnose diastolic dysfunction, with a ratio of >15 indicating severe diastolic dysfunction and a ratio of 8-15 indicating mild to moderate diastolic dysfunction 2.
Treatment Options for Diastolic Dysfunction
- While there are no specific treatments for diastolic dysfunction, managing underlying conditions such as hypertension and coronary artery disease can help alleviate symptoms and slow disease progression 3, 4, 5.
- Medications such as beta-blockers, ACE inhibitors, and calcium channel blockers can be used to control blood pressure and reduce the heart's workload, which can help improve diastolic function 3, 4, 5.