Diastolic heart failure: recognition, diagnosis and management.
A variety of community-based epidemiological studies have suggested that 30-50% of patients with heart failure symptoms appear to have preserved left ventricular (LV) systolic function when assessed by echocardiography or similar techniques suggesting 'diastolic heart failure' (DHF) as its cause. The prognosis of these patients is characterised by morbidity and mortality similar to, but less overt than, patients with systolic dysfunction. However, rates of readmission for symptom control are broadly similar in patients with DHF or in those with systolic impairment. Thus, there are many similarities in the portrayal of both systolic and DHF but equally; there are also many key differences. Certainly, while there are several successful therapies for patients with systolic heart failure, the management of patients with DHF is poorly defined. In this review, the gaps in current knowledge and practice, which is creating this therapeutic void will be addressed.
Goyal
Deepak
D
University Department of Medicine, City Hospital, Birmingham B18 7QH, UK.
Choudhary
Anirban
A
Lip
Gregory Y H
GY
MacFadyen
Robert J
RJ
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D003971:Diastole; D004232:Diuretics / Q000627:therapeutic use; D004452:Echocardiography; D006321:Heart / Q000000981:diagnostic imaging; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009566:Nitrates / Q000627:therapeutic use; D011877:Radionuclide Imaging; D012084:Renin-Angiotensin System / Q000187:drug effects; D014665:Vasodilator Agents / Q000627:therapeutic use
D000889:Anti-Arrhythmia Agents; D004232:Diuretics; D009566:Nitrates; D014665:Vasodilator Agents; D020097:Natriuretic Peptide, Brain