[Diagnosis and therapy for diastolic heart failure]

Area of Science:

• Cardiology
• Internal Medicine

Context:

• Diastolic heart failure (DHF) accounts for 30-50% of heart failure cases.
• Prognosis of DHF is comparable to systolic heart failure.
• Diagnosis relies on clinical heart failure criteria with preserved left ventricular ejection fraction (>40-50%).

Purpose:

• To review the current understanding and treatment strategies for diastolic heart failure.
• To highlight the diagnostic role of natriuretic peptides.
• To outline a therapeutic approach in the absence of extensive clinical trial data.

Summary:

• Treatment for DHF is primarily based on addressing causal factors like hypertension and coronary heart disease.
• Management includes heart rate control and fluid congestion relief.
• A combined therapeutic strategy involving diuretics, antihypertensives, and angiotensin antagonists is recommended.

Impact:

• Brain natriuretic peptide measurements may become crucial for future diagnosis.
• Limited trial evidence necessitates a pragmatic treatment approach.
• Effective management of DHF can improve patient outcomes and reduce hospitalizations.