Grade 1 diastolic dysfunction?

[WVJon75]

I just received my echo results and am concerned about one fining in particular:grade 1 diastolic dysfunction.  I'm a 36 y/o male 6'2" 200 lbs non smoker and fitness fanatic.  I also however, have severe anxiety/panic issues.  Over the last year or more, I have been very inconsistant with my working out for this reason. When I was 23, I had a dialated heart, not sure of the dimensions, and a reduced EF of 45%.  After taking a few months off from exercise my heart returned to an EF of 55% and just within normal chamber sizes.  LVEDD 57.5mm for example.  I just had an echo done for the first time in three years.  The report says grade 1 diastolic dysfunction.  The other numbers are as follows:
EF 62%
LVEDD 60.6mm
Mild pulmonary insufficiency
borderline right LV enlargement
Everything else was basically normal.  My E/A ratio is 1.26.

I am worried as I do seem less tolerant to exercise these days and have episodes of shortness of breathe that I would like to think is anxiety but really don't beleive it is.  Please help.

Thanks

Jon

[WVJon75]

Thank you very much for your reply, CCFH MD.  No labs have been drawn yet.  Would a BNP level be telling of the severity of the DD?
I have no family history of heart disease.  My dad is 70 and his arteries were perfectly clear when he had his heart cath last month. My cholesterol numbers are reasonably good.  
LDL 134
HDL 56
TRI  45

How much can chamber dimensions vary between different echo tests among different test administrators?  According to this test my LV increased in size by 3mm in 3 years.  In the last 3 years I had actually been much less active then in the years prior to my 2009 echo.

[CCFHeartMD 15]

Hello. It is impossible to give you specific recommendations through internet as I do not have your complete medical record and I have not seen you lab results; so, as a general comment I can tell you that is difficult to understand the diagnosis of diastolic dysfunction with a normal E/A ratio (>0.8). About your dilated heart and decreased EF that changed after stopping doing exercise, it may be a reflection of a subtype of physiologic (appropriate or beneficial) remodeling that is also called athlete heart. Unfortunately I cannot be certain about that without all the information, but I can tell you that there are some echocardiographic tools (e.g. 2d tissue strain) that can guide doctors to try to define if a dilated heart is pathologic (due to a disease) or physiologic (athlete heart). About your chest pain it may be anxiety but in general, the probability of a chest pain to be really ischemia (decreased oxygen supply to the heart due to an artery obstruction), will depend on your risk factors and the characteristics of the chest pain; the decision about doing a stress test or not, and what stress test to do will depend on those factors, and the tests available in the center where you consulted.
Good luck.