From the Guidelines
Grade one diastolic dysfunction is a mild condition where the heart muscle becomes slightly stiff, making it harder for the heart to relax and fill with blood properly, and it is typically characterized by an E/A ratio ≤ 0.8 along with a peak E velocity of ≤50 cm/sec, indicating normal or low left atrial pressure 1. When explaining this condition to a patient, it's essential to emphasize that the heart has two main jobs: squeezing blood out (systolic function) and relaxing to fill with blood (diastolic function). In grade one diastolic dysfunction, the heart muscle has become slightly stiff, making it harder for the heart to relax and fill properly. This is the earliest stage of diastolic dysfunction and often causes no symptoms. It's commonly found during routine heart tests like an echocardiogram. The condition is typically related to aging, high blood pressure, diabetes, or being overweight. Some key points to consider when evaluating diastolic function include:
- The transmitral inflow pattern, which can identify patients with increased left atrial pressure (LAP) 1
- The E/A ratio and peak E velocity, which can indicate normal or low LAP when ≤ 0.8 and ≤ 50 cm/sec, respectively 1
- Additional parameters, such as peak TR velocity, E/e′ ratio, and LA maximum volume index, which can be used to estimate LAP when the E/A ratio and peak E velocity are not conclusive 1 At this early stage, the focus is on controlling underlying conditions rather than treating the diastolic dysfunction directly. This means:
- Taking medications for high blood pressure or diabetes if prescribed
- Maintaining a healthy weight
- Limiting salt intake
- Staying physically active
- Avoiding excessive alcohol Regular follow-up appointments are crucial to monitor heart function, and many people with grade one diastolic dysfunction never progress to more serious stages, especially with good control of risk factors.
From the Research
Describing Grade One Diastolic Dysfunction to a Patient
To describe grade one diastolic dysfunction to a patient, it's essential to explain the condition in simple terms. Diastolic dysfunction occurs when the heart has difficulty relaxing and filling with blood between beats. Grade one diastolic dysfunction is the earliest stage of this condition, where the heart's relaxation is slightly impaired, but it can still fill with blood adequately.
Key Points to Discuss with the Patient
- Diastolic dysfunction is a condition where the heart has trouble relaxing and filling with blood between beats 2.
- Grade one diastolic dysfunction is the earliest stage of this condition, and it may not cause significant symptoms.
- The patient's heart is still able to fill with blood, but it may take a bit longer to relax and fill completely.
- This condition can be associated with hypertension and may increase the risk of cardiovascular morbidity and mortality 2.
Treatment and Management
- The treatment of diastolic dysfunction typically involves managing underlying conditions such as hypertension.
- Medications such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, and diuretics may be prescribed to help improve heart function and reduce blood pressure 2, 3, 4.
- Lifestyle modifications, such as regular exercise, a healthy diet, and stress reduction, can also help manage the condition.
Important Considerations
- It's crucial to work with a healthcare provider to develop a personalized treatment plan.
- Regular monitoring and follow-up appointments can help track the progression of the condition and adjust treatment as needed.
- By understanding the condition and working with a healthcare provider, patients can manage grade one diastolic dysfunction and reduce the risk of complications.