Your Guide to Left Ventricular Diastolic Dysfunction

Left ventricular diastolic dysfunction (LVDD) is a condition that affects your hearts ability to fill up with blood before sending the blood out into your circulation. Your heartbeat has two phases: systole and diastole. During systole, the heart contracts or squeezes, sending blood out to your organs. Diastole is the time when the heart relaxes and can fill back up again, and this is the phase affected when you have LVDD.

Diagnosing LVDD can be difficult because it doesnt always immediately cause symptoms. However, the condition is a contributing factor to heart failure, which makes it important to diagnose and treat. Keep reading to find out more about how LVDD affects your heart and health.

Causes of left ventricular diastolic dysfunction (LVDD)

Advancing age is the most common cause of LVDD. As you age, the hearts fibers arent as elastic. This means they dont snap back in place as well as they used to.

When a person is middle-aged, their risk of diastolic dysfunction is 27 to 43% while an estimated 88% of those ages 85 and older experience diastolic dysfunction.

Conditions that affect the hearts abilities to pump well can also cause LVDD. These conditions include:

  • atrial fibrillation (AFib)
  • coronary artery disease
  • diabetes
  • hypertension
  • obesity

The presence of each of these conditions increases the likelihood that LVDD will lead to heart failure, or when your heart doesnt pump effectively.

Does COVID-19 affect left ventricular diastolic dysfunction?

While theres a lot of research to be done on the effects of COVID-19 on the heart, some studies have identified that people hospitalized with COVID-19 experience LVDD. One study estimated about 16% of those with COVID-19 experienced LVDD.

Researchers are identifying potential COVID-19 side effects, but it will take more time to determine if these effects are reversed once a person gets better.

Grades of left ventricular diastolic dysfunction

Doctors or healthcare professionals will typically use a testing approach called an echocardiogram to measure your LVDD. There are two approaches to echocardiogram: a transthoracic echocardiogram (TTE) and a transesophageal echocardiogram (TEE).

  • A TTE is a noninvasive test where a doctor will use an ultrasound probe placed on your chest to view how well your heart is working.
  • A TEE involves inserting a probe down your throat to view the heart via the esophagus. This test is more invasive but can sometimes be more accurate.

Based on what doctors see in the ventricle, doctors may stage or divide LVDD into several phases:

  • Normal: no abnormal measurements of diastolic dysfunction
  • Mild: one abnormal measurement of diastolic dysfunction
  • Moderate: two abnormal measurements of diastolic dysfunction
  • Severe: three abnormal measurements of diastolic dysfunction

These measurements help doctors keep track of the changing pressure in your heart. You can ask a doctor about what your stage means related to your health and medical management.

Signs and symptoms of left ventricular diastolic dysfunction

LVDD doesnt always cause symptoms. An estimated 1.3 to 1.4% of people have asymptomatic LVDD. Doctors have a whole classification of heart failure called stage B heart failure, which is asymptomatic heart failure. However, asymptomatic heart failure can progress to cause symptoms over time.

If your LVDD progresses to heart failure, you may start to have symptoms related to not getting enough oxygen to your bodys tissues. Examples of these symptoms include:

  • difficulty exercising
  • fatigue
  • frequent coughing
  • shortness of breath, particularly with physical activity
  • swelling, especially in the legs and abdomen

These symptoms are common in different types of heart failure and may be seen in LVDD as well.

Treatment options for left ventricular diastolic dysfunction

Treatment options for LVDD include a combination of medications and lifestyle changes. Examples of medical treatments include blood-pressure-lowering medications, including:

  • angiotensin converting enzyme (ACE) inhibitors, such as benazepril, lisinopril, or ramipril
  • angiotensin receptor blockers (ARBs), such as olmesartan or losartan
  • beta-blockers, such as atenolol, carvedilol, or metoprolol

Some lifestyle treatments for LVDD include:

  • eating a heart-healthy diet
  • exercise
  • limiting excess alcohol intake
  • quitting smoking if you smoke

Managing comorbid conditions, such as diabetes and high blood pressure, can also help reduce the progression to severe heart failure.

Are treatments for LVDD covered by insurance or Medicare?

Medicare requires prescription drug plans to cover at least two drugs for every prescription drug category. Examples include antipsychotics, antidepressants, and immunosuppressants. These plans would also cover medications to treat heart failure, including different types of antihypertensives.

Many antihypertensive medications are available as generic medications. Medicare and insurance plans typically cover generic medications, and these are usually more affordable.

However, if youre having difficulty paying for a medication to treat your LVDD, talk with a doctor to see if you could take another medication thats effective but less expensive.

Outlook for people with left ventricular diastolic dysfunction (LVDD)

LVDD is one of the contributing factors to diastolic heart failure. Those with diastolic heart failure will have signs and symptoms of heart failure as well as LVDD However, those with diastolic heart failure usually have a normal ejection fraction.

People with diastolic heart failure have a higher risk of morbidity and mortality than people who dont. Even when asymptomatic, LVDD can progress to heart failure and decreased survival.

However, if a doctor diagnoses you with LVDD and treats you before you have symptoms, your outlook can improve.

Living with left ventricular diastolic dysfunction

If a doctor has diagnosed you with a form of LVDD, its understandable to be concerned and look for support. Here are some organizations that can help:

  • The American Heart Association offers support for those with heart-related disorders and their caregivers.
  • Heart Failure Matters offers education and support for those with heart failure in all its stages.
  • WomenHeart offers peer- to-peer support and has more than 100 support groups across the country for those who identify as women.

Takeaway

LVDD is a condition thats more likely to occur as you age. If a doctor finds it earlier, the condition can be a predictor of potential progression to heart failure.

Making lifestyle and medication changes can help you to lead a healthier, more heart-friendly lifestyle. If youre displaying any symptoms of heart failure, talk with a doctor as soon as possible.