title: Heart failure with preserved EF: a bird eye view.
abstract: The concept of ''diastolic'' heart failure grew out of the observation that many patients who have the symptoms and signs of heart failure had an apparently normal left ventricular (LV) ejection fraction. Thus it was assumed that since systolic function was ''pre- served'' the problem must lie in diastole, although it is not clear by whom or when this assumption was made. Nevertheless, many guidelines followed on how to diagnose ''diastolic'' heart failure backed up by indicators of diastolic dysfunction derived from Doppler echoardiography. Diastolic heart failure is associated with a lower annual mortality rate of approximately 8% as compared to annual mortality of 19% in heart failure with systolic dysfunction, however, morbidity rate can be substantial. Thus, diastolic heart failure is an important clinical disorder mainly seen in the elderly patients with hypertensive heart disease. Early recognition and appropriate therapy of diastolic dysfunction is advisable to prevent further progression to diastolic heart failure and death. There is no specific therapy to improve LV diastolic function directly. Medical therapy of diastolic dysfunction is often empirical and lacks clear-cut pathophysiologic concepts. Nevertheless, there is growing evidence that calcium channel blockers, beta-blockers, ACE-inhibitors and ARB as well as nitric oxide donors can be beneficial. Treatment of the underlying disease is currently the most important therapeutic approach.
authors.affiliation: Wake Forest School of Medicine, 295 Chelsea Village Cir, Winston Salem, NC 27103, USA.
authors.forename: Fahad
authors.initials: F
authors.lastname: Aziz
authors.affiliation: Wake Forest School of Medicine, 295 Chelsea Village Cir, Winston Salem, NC 27103, USA.
authors.forename: Luqman-Arfath
authors.initials: LA
authors.lastname: Thazhatauveetil-Kunhahamed
authors.affiliation: Wake Forest School of Medicine, 295 Chelsea Village Cir, Winston Salem, NC 27103, USA.
authors.forename: Chijioke
authors.initials: C
authors.lastname: Enweluzo
authors.affiliation: Wake Forest School of Medicine, 295 Chelsea Village Cir, Winston Salem, NC 27103, USA.
authors.forename: Misbah
authors.initials: M
authors.lastname: Zaeem
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003971:Diastole; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D011875:Radionuclide Angiography; D013318:Stroke Volume; D018615:Ultrasonography, Doppler, Color; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000628:therapy
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers