[Diastolic heart failure:a disease in search of his own identity].
Epidemiological surveys on congestive heart failure (CHF) in the community settings reveal that 30-70% of CHF patients presents a normal (> 50%) or only mildly depressed left ventricular ejection fraction. Usually it is tought that these patients suffer of "diastolic" heart failure (DHF). However, some authors contest the "real" existence of isolated DHF. This is a consequence of known difficulty to evaluate the diastolic function with available tests, the lack of a "simple" and unequivocal marker of diastolic dysfunction, the frequent co-existence of associated chronic diseases that may act as confounding factors. Accordingly, an integrated approach to patients with suspected DHF by means of an accurate clinical evaluation, combined with a Doppler-echocardiographic examination, brain natriuretic peptide (BNP) dosage and functional capacity tests (cardiopulmonary exercise test, 6-minute walk test) may represent a strategy in order to overcome such diagnostic difficulties.
Tarantini
Luigi
L
Divisione di Cardiologia, O.C. S. Martino, Viale Europa 22, 32100 Belluno-I.
Faggiano
Pompilio
P
Cioffi
Gianni
G
Russo
Paola
P
Catania
Giuseppe
G
D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D016277:Ventricular Function, Left / Q000502:physiology