Diastolic heart failure: the current understanding and approach for management with focus on intensive care unit patients.
Multiple recent epidemiologic studies have highlighted the importance of diastolic heart failure (DHF) as a public health problem. Approximately half of patients presenting with symptomatic heart failure (HF) have DHF and they suffer from morbidity and mortality comparable to those with systolic HF. Our understanding of the pathophysiology of DHF has evolved rapidly over the last decade, and the associated echo-Doppler findings that assist with its diagnosis are greatly refined. Recently, there has been increased recognition of the role of diastolic dysfunction and DHF in the care of critically ill patients, including those admitted to noncardiac units. The purpose of this review is to provide an up-to-date summary of the concepts of the pathophysiology of DHF. In addition, we provide an overview of the diagnostic approaches, prognostic identifiers, and associated comorbidities that make DHF more resistant to manage with a focus of the patients admitted to the intensive care unit. The current approach to managing patients with DHF is also reviewed.
Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Wassef
W
Karrowni
Kanu
K
Chatterjee
D003971:Diastole; D054144:Heart Failure, Diastolic / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D007362:Intensive Care Units; D016276:Ventricular Function / Q000502:physiology