Predictors of Heart Failure With Preserved Ejection Fraction in Patients With Metabolic Syndrome and Preclinical Diastolic Dysfunction

to evaluate differences in echocardiographic parameters between patients with preclinical diastolic dysfunction (PDD) and heart failure with preserved ejection fraction (HFpEF) and to identify predictors of transition from PDD to HFpEF. Echocardiographic parameters were recorded in 325 patients with PDD and 50 healthy subjects. PDD and HFpEF were diagnosed by tissue Doppler imaging of the left ventricle (LV) during exercise stress test and detection of symptoms of heart failure. There were significant differences between both groups of patients and control group as well as between groups of patients with PDD and HFpEF in LV mass index, maximal left atrial (LA) volume index, systolic blood pressure, LV and LA parameters of longitudinal strain and strain rate. Patients with PDD and subsequent development of HFpEF had high values of LA stiffness and interatrial mechanical dyssynchrony. These parameters were independent predictors of HFpEF development in patients with PDD. Predictors of HFpEF identified in this study provide an opportunity for early detection of patients with PDD with high risk of HFpEF development.