Table of ContentsView AllTable of ContentsWhat Is Diastolic Dysfunction?Causes and Risk FactorsGrade 1 Diastolic DysfunctionOther GradesTreatment and Prevention
Table of ContentsView All
View All
Table of Contents
What Is Diastolic Dysfunction?
Causes and Risk Factors
Grade 1 Diastolic Dysfunction
Other Grades
Treatment and Prevention
Grade 1diastolicdysfunction occurs when the left lower chamber of theheart(the left ventricle) has trouble relaxing in between beats because it has stiffened over time. It interferes slightly with the heart’s most important job: getting oxygen-rich blood to the rest of the body.
This article discusses grade 1 diastolic dysfunction. It explains the causes and risk factors that can lead to diastolic dysfunction, its symptoms, and how diastolic dysfunction is diagnosed and managed.
Feelingshort of breathis the main symptom of diastolic dysfunction. Unlikecongestive heart failure(CHF), with similar episodes that take hours or days to develop, breathing problems come on quickly. They can cause sudden and severe respiratory distress.
Treatment for diastolic dysfunction includes diet, exercise, and other lifestyle changes. These steps can help to prevent or slow progression to a higher grade that requires medication and surgeries.
How Your Heart BeatsA single heartbeat is divided into two basic phases, thesystole(systolic) and the diastole (diastolic). During the systole phase, both ventricles contract, or squeeze. The left ventricle pushes blood into the arteries and out to the body. The right ventricle pumps blood into the lungs to pick up oxygen. During diastole, both ventricles relax as they refill with blood that is delivered from the atria of the heart.
How Your Heart Beats
A single heartbeat is divided into two basic phases, thesystole(systolic) and the diastole (diastolic). During the systole phase, both ventricles contract, or squeeze. The left ventricle pushes blood into the arteries and out to the body. The right ventricle pumps blood into the lungs to pick up oxygen. During diastole, both ventricles relax as they refill with blood that is delivered from the atria of the heart.
The Heart’s Chambers and Valves
Age is the number one risk factor for developing grade 1 diastolic dysfunction. It is common, and fit and healthy people over 60 years of age can develop this condition. The condition is also more common in those who have been diagnosed with other conditions, including:
Obesity, or a BMI (body mass index) of 30 or above, is a risk factor. However, keep in mind that BMI is a dated, flawed measure. It does not take into account factors such asbody composition, ethnicity, sex, race, and age. Even though it is a biased measure, BMI is still widely used in the medical community because it’s an inexpensive and quick way to analyze a person’s potential health status and outcomes.
Understanding Blood Pressure
Other risk factors include:
Smoking has a direct impact on the heart muscle, leading to the stiffening, thickening, and impaired filling that define diastolic dysfunction. Nicotine damages blood vessels and reduces oxygen levels in the heart, making it work faster and harder.
Alcohol and sugar can both increasetriglycerides(a type of lipid, or fat, found in blood) and HDL, worsening arterial damage. Similarly, refined grains and starches act like sugar in the body, with the same effects.
Saturated fats from animal sources also cause oxidative stress (free radical damage, which is like the human version of rust) and clog cardiac arteries, as do trans fats (particularly partially hydrogenated fats). This can lead to coronary artery disease, a risk factor for diastolic dysfunction.A sedentary lifestyle puts you at higher risk for heart disease.
Healthcare providers assign a grade level when treating diastolic dysfunction. The grade indicates how severe the condition is.
Grade 1 diastolic dysfunction is sometimes referred to as diastolic failure or heart failure with preserved ejection fraction (HFpEF). People with Grade 1 diastolic dysfunction have evidence of abnormal diastolic function and may or may not have symptoms.
Diastolic dysfunction does not necessarily translate to a diagnosis ofheart failure, and preserved ejection fraction means that the percentage is within the normal range, or over 50%.
What Is the Ejection Fraction?
Grade 1 diastolic dysfunction is referred to as impaired relaxation. For patients with this grade of dysfunction, the diastolic filling of the ventricles is a bit slower than it should be, but other calculations are normal.
Some degree of dysfunction is expected in most people over the age of 65, but in one study, research using echocardiographic (cardiac ultrasound) measurements showed that up to 27.3% of the general population has some degree of dysfunction.Most otherwise healthy people with grade 1 diastolic dysfunction have a normallife expectancy.
Symptoms
While some people with grade 1 diastolic dysfunction are asymptomatic, others may experience symptoms, such as:
Other Grades of Diastolic Function
As diastolic dysfunction progresses, it is diagnosed in more advanced grades. These include:
Based on the incidence of each grade, it is likely that most people (approximately 76.6% or more) with grade 1 diastolic dysfunction will not progress to higher grades of the condition.
Diagnostic tests like the echocardiogram are a key part of assessing and treating diagnostic dysfunction. It uses sound waves, or ultrasound, to capture images of your heart. Other tests may include the following:
Treating Diastolic Dysfunction and Diastolic Heart Failure
For people with no diastolic dysfunction, or who are only at grade 1, the good news is that lifestyle changes can make a significant difference in managing andtreating diastolic dysfunction. You can reduce the risk of developing advanced heart failure and improve your heart health.
Lifestyle
The following measures lower the risk of developing or progressing with stage 1 diastolic dysfunction:
Medications
Medications for conditions that put you at risk for diastolic dysfunction include those to control diabetes, blood pressure, LDL and HDL cholesterol, triglycerides, and obesity.They include:
If you are not already on these medications for the conditions above and your grade 1 diastolic dysfunction advances to a higher grade, your healthcare provider may consider medication. Surgery also is an option for advanced cases of diastolic dysfunction.
Summary
Grade 1 diastolic dysfunction is a common condition that affects many people over the age of 60, including those who are otherwise healthy and fit. Some people don’t experience symptoms, while others may have shortness of breath. The symptoms and their severity can worsen if diastolic dysfunction progresses into other stages.
Talk to your healthcare provider if you have concerns about symptoms. Lifestyle changes are often recommended. These include quitting smoking, reducing dietary fat, and getting more exercise and quality sleep. When lifestyle interventions are not enough, medication or even surgery may be needed.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Jeong EM, Dudley SC.Diastolic dysfunction: Potential new diagnostics and therapies.Circ J. 2015;79(3):470-477. doi:10.1253/circj.CJ-15-0064
Del Buono MG.Primary and secondary diastolic dysfunction in heart failure with preserved ejection fraction.Am J Cardiol. 2018;122(9):1578-1587. doi:10.1016/j.amjcard.2018.07.012
Popovic D, Alogna A, Omar M, Sorimachi H, Omote K, Reddy YNV,et al.Ventricular stiffening and chamber contracture in heart failure with higher ejection fraction.Eur J Heart Fail. 2023 May;25(5):657-668. doi: 10.1002/ejhf.2843.
Tsao CW, Lyass A, Larson MG, et al.Prognosis of adults with borderline left ventricular ejection fraction.JACC Heart Fail. 2016;4(6):502-510. doi:10.1016/j.jchf.2016.03.003
Baptist Health.Diastolic Heart Failure.
Kossaify A, Nasr M. Diastolic dysfunction and the new recommendations for echocardiographic assessment of left ventricular diastolic function: Summary of guidelines and novelties in diagnosis and grading.J Diagn Med Sonogr. 2019;35(4):317-325. doi:10.1177/8756479319836781
Litwin SE. Zile MR.Should we test for diastolic dysfunction? How and how often?J Am Coll Cardiol Img. 2020;13(1):297–309. doi:10.1016/j.jcmg.2019.02.029
American Heart Association.Diet and lifestyle recommendations.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
