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Correspondence
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Volume 352:307-308 January 20, 2005 Number 3
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Diastolic Heart Failure

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by Aurigemma, G. P.
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To the Editor: Aurigemma and Gaasch (Sept. 9 issue)1 do not mention diabetes mellitus as a frequent cause of diastolic heart failure. In the Strong Heart Study,2 the investigators reported an extremely high prevalence (80 percent) of left ventricular diastolic dysfunction among normotensive persons with diabetes. The relationship was independent of other confounding factors, such as blood pressure, systolic function, and age, and it was stronger for patients with worse glycemic control. Others have also reported a high frequency of diastolic dysfunction among normotensive patients with diabetes.3 Increased matrix collagen, interstitial fibrosis, myocardial microangiopathy, and myocyte hypertrophy are common findings . . . [Full Text of this Article]



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