Question:

Do you think Diastolic Dysfunction stage 1 is over diagnosed?

I saw the points below on a blog by a cardiologist and wondered if you would concur. “the echocardiologists considered it fashionable for quite a long time (many have changed since then!) to report all patients with reversed E :A ratio in the mitral inflow doppler profile as diastolic dysfunction. This has resulted in thousands of asymptomatic, healthy people getting labeled as grade 1 diastolic dysfunction, undermining the importance of this entity.
The fact of the matter is true diastolic dysfunction is indeed dangerous, if not more dangerous than systolic dysfunction for the simple reason there is no specific treatment for this condition. To improve the specificity to diagnose genuine LV diastolic dysfunction, it is suggested to remove grade 1 diastolic dysfunction from the literature”.

Submitted by Rich from Pennsylvania on 04/16/2016

Answer:
by Michael J. Mihalick, MD

Dear Rich:
While I agree with the statement that Grade 1 diastolic dysfunction is over-labeling, it will never be removed from the literature. It is a common finding in adults >60 who are otherwise normal and could be considered part of the aging process. The term diastolic dysfunction should be reserved for higher grades that are associated with additional findings. Echocardiographers have no problem pointing out that pulmonary venous flow patterns associated with elevated LA pressure in older adults are considered normal in children and young adults. I think that a similar statement would be appropriate when this is reported as an isolated finding in an otherwise normal study. Sincerely.