title: Diastolic heart failure in dialysis patients: mechanisms, diagnostic approach, and treatment.
abstract: Heart failure (HF) is very common in the general population, and risk factors for HF, such as coronary artery disease, diabetes, obesity, and hypertension, are frequently present in patients with CKD. Therefore, HF is also an important cause of morbidity and mortality in this population. Diastolic heart failure (DHF), also called HF with preserved ejection fraction, refers to a clinical syndrome in which patients have symptoms and signs of HF, normal or near normal left ventricular (LV) systolic function, and evidence of diastolic dysfunction (e.g., abnormal LV filling and elevated filling pressure). Recent data suggest that HF with normal ejection fraction is even more common in patients than HF with low ejection fraction, including those on hemodialysis. Not surprisingly, DHF is a strong predictor of death in CKD patients. In this article, we review the information available on the mechanisms, clinical presentation, impact, and potential interventions in DHF based on evidence from CKD patients, as well as evidence from the general population potentially applicable to the CKD population.
authors.affiliation: Center for Health and Biological Sciences, Pontificia Universidade Católica do Paraná, Curitiba, Brazil.
authors.forename: Roberto
authors.initials: R
authors.lastname: Pecoits-Filho
authors.forename: Sérgio
authors.initials: S
authors.lastname: Bucharles
authors.forename: Silvio H
authors.initials: SH
authors.lastname: Barberato
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D015150:Echocardiography, Doppler / Q000379:methods*; D005919:Glomerular Filtration Rate; D054144:Heart Failure, Diastolic / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D011379:Prognosis; D006435:Renal Dialysis; D012307:Risk Factors; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D013318:Stroke Volume; D014665:Vasodilator Agents / Q000627:therapeutic use*; D016277:Ventricular Function, Left / Q000502:physiology*; D017725:Ventricular Pressure
chemical_list: D049994:Sodium Potassium Chloride Symporter Inhibitors; D014665:Vasodilator Agents