From the Research
For an asymptomatic patient with Grade 1 diastolic dysfunction found in 2013, I recommend rechecking with an echocardiogram every 1-3 years, depending on the presence of risk factors, as supported by the most recent study 1 that highlights the importance of monitoring diastolic dysfunction to prevent progression to heart failure. The frequency of monitoring should be tailored to the individual's risk profile, with yearly monitoring recommended for those with conditions like hypertension, diabetes, coronary artery disease, or obesity, and evaluation every 2-3 years for those without these risk factors. During these follow-up appointments, the healthcare provider should also assess for any new symptoms like shortness of breath, fatigue, or decreased exercise tolerance, as these could indicate progression of the condition. Grade 1 diastolic dysfunction (impaired relaxation pattern) is often an early finding that may remain stable for years, especially with good control of underlying conditions, as noted in the study 2 that emphasizes the importance of early detection and management of diastolic dysfunction. The purpose of monitoring is to detect progression to more advanced stages of diastolic dysfunction, which carry higher risks of developing heart failure symptoms. Lifestyle modifications including weight management, regular exercise, sodium restriction, and optimal control of blood pressure and diabetes are important for preventing progression of diastolic dysfunction, as suggested by the study 1 that highlights the role of left atrial strain in assessing diastolic function. It is also important to consider the prognostic relevance of diastolic dysfunction, as noted in the study 3 that developed a score for identifying diastolic dysfunction according to the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging recommendations. However, the study 4 that validated the 2016 ASE/EACVI guideline for diastolic dysfunction found limited diagnostic accuracy, emphasizing the need for careful interpretation of echocardiographic findings. Overall, a comprehensive approach that incorporates regular monitoring, lifestyle modifications, and careful interpretation of echocardiographic findings is essential for managing asymptomatic patients with Grade 1 diastolic dysfunction.