| Objective:Diastolic heart failure(DHF) is defined as symptoms of heart failure in patients with normal left ventricular ejection function and diastolic dysfunction.The prognosis of DHF mainly depends upon patient's age,sex, ejection fraction and underlying diseases.The Annual fatality rate of DHF is 5%～8%,and of systolic heart failure(SHF) is 10%～15%.Compared with age matching control group(the fatality rate is only 1%),the prognosis of DHF patients is merely lower than SHF patients,but still is far higher than healthy persons.Accordingly,in order to early intervention of DHF,it's necessary to research the early diagnosis methods of DHF.In recent years,DHF was realized and emphasized by more physicians,but the reports mainly were experimental and retrospective studies.The researches of large population were rare in other countries,and were even seldom in domestic.About 30%～50%of heart failure patients were SHF combined DHF or only DHF,and the prevalence increased with age.Thus,in order to early intervention of DHF,it is very important to screening DHF in community.We carried out a clinical investigate of old population in communities.By recording and analyze the morbidity and mortality of DHF,age,underling diseases,medications,echocardiography and neuroendocrine factors examinations to identify DHF's high risk factors.Methods:From January 2008 to March 2009,all aged personnel that participated health examination from 12 outpatient department of Chinese PLA were included.They were assigned to following 3 groups:DHF group(n=190), SHF group(n=116),comparison group(n=453).Everyone's medical history, physical examination,and medications were detailed documented.Then,they were preceded with echocardiography(LVEF,Sm,E/A,PVs/PVd,PVaD-AD,Vp,E/Em,E/Vp) and neuroendocrine factors(NT-proBNP,RN,AngⅡ,ALD,ET) examinations.Finally,all data were compared and analyzed.Results:The mean age of DHF group was 70.51±7.48 years old,among the total.The mean age of DHF group was higher than comparison group,the incidence rate of DHF increased with age.The average heart rate of DHF group was 73.54±11.24 bpm,compared with comparison group,there was no statistically significant.The contractive pressure(mean 131.11±12.42mmHg) and diastolic pressure(mean 79.85±9.02mmHg) of DHF group were higher than comparison group.DHF group showed higher incidence of coronary heart disease (53.2%),primary hypertension(71.1%),diabetes(19.5%),and arrhythmias (8.4%),when compared with comparison group.In patients with underlying diseases of primary hypertension and coronary heart disease,the incidence of DHF raised up with disease time.Subjects in DHF group tookβ-blocker(49.5%), ACEI or ARB(52.1%),cerebrocrast(56.3%) more frequent than in comparison group.There were no significant differences with LVEF between the two groups. The decrease of Sm showed significant difference.E/A,Vp decreased,PVaD-AD, E/Em and E/Vp showed significant rise up.The density of NT-proBNP,AngⅡ,RN,ET1,ALD all raised up significantly.Conclusion:1) Age is an independent factor that impacts cardiac diastolic function,the incidence of DHF increases with aging.2) Primary hypertension, coronary heart disease(including stable angina pectoris and old myocardial infarction),and diabetes mellitus are three most common underlying diseases of DHF.The incidence of DHF has positive correlation with the disease time of primary hypertension and coronary heart disease,but has no correlation with the disease time of diabetes mellitus.3) Although DHF patients' average heart rates remain unchanged,their blood pressure(including average systolic and diastolic pressure) elevated.DHF occurs at the prophase of cardiac dysfunction.4) Cerebrocrast,ACEI or ARB,P-blocker are the predominate medicines that be used to treat DHF.5) DHF patients' diastolic function impaired obviously,but systolic function changed little.6) NT-proBNP,ET,RN,AngⅡ,ALD increased obviously when DHF occurred,they might be the co-precipitation factors that cause DHF's occurrence and development.
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