Which comorbidity is more commonly linked to diastolic dysfunction than to systolic dysfunction?

• A. Myocardial infarction
• B. Hypertension
• C. Myocarditis
• D. Valvular disease

Answer: (B)

Hypertension fosters diastolic dysfunction by creating chronic pressure overload on the left ventricle. Over time this prompts concentric left ventricular hypertrophy, which makes the ventricle stiffer and less compliant. When the heart has to fill, the stiff ventricle resists filling, raises filling pressures, and impairs diastolic relaxation, all of which are hallmarks of diastolic dysfunction and often occur with preserved ejection fraction (HFpEF). In contrast, myocardial infarction directly damages muscle and typically causes systolic dysfunction (reduced pumping ability) due to scar and loss of contractile tissue. Myocarditis can disrupt both systolic and diastolic function, and valvular disease can affect either depending on the lesion, but the classic link to diastolic dysfunction is long-standing hypertension. Therefore hypertension is the comorbidity most commonly associated with diastolic dysfunction.