Diastolic heart failure: state of the science on best treatment practices.
OBJECTIVE
The purpose of this article is to increase awareness among nurse practitioners (NPs) of the current state of the science on diastolic heart failure (DHF), the American College of Cardiology (ACC) and the American Heart Association (AHA) guidelines for DHF, and pathophysiology, diagnosis, and nonpharmacological and pharmacological management of DHF.


METHODS
The articles included in the review of the state of the science were retrieved by a search of PUBMED literature using the following key search terms: heart failure, diastolic heart failure, preserved systolic function, heart failure management, treatment of diastolic heart failure, treatment of diastolic dysfunction, and treatment of preserved systolic function. Current published guidelines from the ACC and AHA were reviewed to establish clinical recommendations for patients with DHF.


CONCLUSIONS
The state of the science and clinical recommendations for DHF are in the early stages compared to those for systolic heart failure (SHF). The need for more randomized clinical trials on nonpharmacological and pharmacological management and the development of standardized guidelines for DHF patients are clearly apparent.


CONCLUSIONS
Both nonpharmacologic and pharmacologic management are effective and necessary to control the clinical signs and symptoms of DHF and improve overall quality of life. Successful tailoring of a treatment plan to suit each individual patient's needs and including the family are important for the NP to consider.
Reddersen
Lindsey Austin
LA
Department of Adult Cardiac Electrophysiology, Duke University Medical Center, Durham, North Carolina, USA.
Redderson
Lindsey Austin
LA
Keen
Crystal
C
Nasir
Laura
L
Berry
Diane
D
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D019985:Benchmarking / Q000458:organization & administration*; D004232:Diuretics / Q000627:therapeutic use; D016903:Drug Monitoring / Q000451:nursing; D004359:Drug Therapy, Combination; D055317:Evidence-Based Practice / Q000458:organization & administration*; D005190:Family / Q000523:psychology; D006301:Health Services Needs and Demand; D054144:Heart Failure, Diastolic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D009722:Nurse Practitioners / Q000458:organization & administration*; D010347:Patient Care Planning; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists