Review
. 2004 Jun 1;69(11):2609-16.
Affiliations
- PMID: 15202695
Free article
Review
Diastolic heart failure: challenges of diagnosis and treatment
Cecilia Gutierrez et al. Am Fam Physician. 2004.
Free article
Abstract
Diastolic heart failure, a major cause of morbidity and mortality, is defined as symptoms of heart failure in a patient with preserved left ventricular function. It is characterized by a stiff left ventricle with decreased compliance and impaired relaxation, which leads to increased end diastolic pressure. Signs and symptoms are similar to those of heart failure with systolic dysfunction. The diagnosis of diastolic heart failure is best made with Doppler echocardiography. Based on current knowledge, pharmacologic treatment of diastolic heart failure should focus on normalizing blood pressure, promoting regression of left ventricular hypertrophy, avoiding tachycardia, treating symptoms of congestion, and maintaining normal atrial contraction when possible. Diuretic therapy is the mainstay of treatment for preventing pulmonary congestion, while beta blockers appear to be useful in preventing tachycardia and thereby prolonging left ventricular diastolic filling time. Angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers may be beneficial in patients with diastolic dysfunction, especially those with hypertension. Evidence from adequately powered randomized controlled trials, however, is not available yet. The outcomes of ongoing clinical trials may provide much-needed information to move from intuitive treatment to therapy based on evidence that matters: decreased morbidity and mortality and improved quality of life.
Similar articles
Heart failure with normal left ventricular ejection fraction: what is the evidence?
Kindermann M, Reil JC, Pieske B, van Veldhuisen DJ, Böhm M. Kindermann M, et al. Trends Cardiovasc Med. 2008 Nov;18(8):280-92. doi: 10.1016/j.tcm.2008.12.003. Trends Cardiovasc Med. 2008. PMID: 19345315 Review.
Management of diastolic heart failure--a practical review of pathophysiology and treatment trial data.
Wu EB, Yu CM. Wu EB, et al. Int J Clin Pract. 2005 Oct;59(10):1239-46. doi: 10.1111/j.1368-5031.2005.00642.x. Int J Clin Pract. 2005. PMID: 16178994 Review.
Therapy for diastolic heart failure.
Little WC, Brucks S. Little WC, et al. Prog Cardiovasc Dis. 2005 May-Jun;47(6):380-8. doi: 10.1016/j.pcad.2005.02.004. Prog Cardiovasc Dis. 2005. PMID: 16115517 Review.
[Dyspnea and normal systolic function].
Hasenfuss G, Hermann HP, Pieske B. Hasenfuss G, et al. Herz. 2004 Sep;29(6):602-8. doi: 10.1007/s00059-004-2621-1. Herz. 2004. PMID: 15912435 German.
[Heart failure due to diastolic dysfunction: the treatment principles].
Pinamonti B, di Lenarda A, Sinagra G. Pinamonti B, et al. Ital Heart J Suppl. 2000 Apr;1(4):469-80. Ital Heart J Suppl. 2000. PMID: 10832133 Review. Italian.
Cited by
Extracellular stiffness induces contractile dysfunction in adult cardiomyocytes via cell-autonomous and microtubule-dependent mechanisms.
Vite A, Caporizzo MA, Corbin EA, Brandimarto J, McAfee Q, Livingston CE, Prosser BL, Margulies KB. Vite A, et al. Basic Res Cardiol. 2022 Aug 25;117(1):41. doi: 10.1007/s00395-022-00952-5. Basic Res Cardiol. 2022. PMID: 36006489
Mitochondria Isolated from Hearts Subjected to Ischemia/Reperfusion Benefit from Adenine Nucleotide Translocase 1 Overexpression.
Dörner A, Lynetskiy O, Euler G, Landmesser U, Schlüter KD, Heger J. Dörner A, et al. Membranes (Basel). 2021 Oct 29;11(11):836. doi: 10.3390/membranes11110836. Membranes (Basel). 2021. PMID: 34832065 Free PMC article.
Relationship of left ventricular and atrial dimensions with moderate to severe left ventricular diastolic dysfunction (grade II and above).
Hamza M, Fatima M, Masood M, Masood HU, Tasleem G, Ahmed H, Nadir M, Satti Z. Hamza M, et al. Afr Health Sci. 2020 Dec;20(4):1749-1753. doi: 10.4314/ahs.v20i4.27. Afr Health Sci. 2020. PMID: 34394235 Free PMC article.
The Prognostic Significance of Anemia in Patients With Heart Failure: A Meta-Analysis of Studies From the Last Decade.
Xia H, Shen H, Cha W, Lu Q. Xia H, et al. Front Cardiovasc Med. 2021 May 13;8:632318. doi: 10.3389/fcvm.2021.632318. eCollection 2021. Front Cardiovasc Med. 2021. PMID: 34055927 Free PMC article.
Physician Variability in Diastology Reporting in Patients With Preserved Ejection Fraction: A Single Center Experience.
Patel R, Desai AR, Patel P, Vanka V, Ghadiam H, Kizhakekuttu T. Patel R, et al. Cureus. 2020 Jul 8;12(7):e9062. doi: 10.7759/cureus.9062. Cureus. 2020. PMID: 32782880 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
- American Academy of Family Physicians
Other Literature Sources
- The Lens - Patent Citations
Medical
- ClinicalTrials.gov
- MedlinePlus Health Information