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Systolic and diastolic heart failure: different phenotypes of the same disease?

Gilles W De Keulenaer1, Dirk L Brutsaert

  • 1Department of Physiology, University of Antwerp, Antwerp, Belgium. gilles.dekeulenaer@ua.ac.be

European Journal of Heart Failure
|August 4, 2006
PubMed

Insights

Systolic and diastolic heart failure may represent different clinical presentations of a single disease, challenging traditional views. This unified perspective offers new paradigms for understanding chronic heart failure progression.

Area of Science:

  • Cardiology
  • Pathophysiology
  • Heart Failure Research

Background:

  • Traditional chronic heart failure (CHF) concepts emphasize ventricular systolic dysfunction's hemodynamic impact.
  • The pathophysiology of diastolic heart failure (HFpEF) remains unclear, impacting diagnosis and management.
  • Recent findings suggest systolic and diastolic heart failure are more interconnected than previously thought.

Purpose of the Study:

  • To re-evaluate the relationship between systolic and diastolic heart failure.
  • To propose novel pathophysiological paradigms for chronic heart failure.
  • To integrate new insights into a unified disease model.

Main Methods:

  • Review of existing literature on chronic heart failure pathophysiology.
  • Analysis of recent measurements of regional myocardial systolic function in HFpEF patients.
  • Conceptual interpretation of integrated systolic and diastolic dysfunction.

Main Results:

  • Systolic and diastolic heart failure may not be distinct diseases but part of a phenotypic spectrum.
  • Evidence suggests a closer relationship between systolic and diastolic dysfunction.
  • A unified pathophysiological trajectory for heart failure is proposed.

Conclusions:

  • Chronic heart failure may be a single disease with varied clinical presentations.
  • Novel paradigms integrating systolic and diastolic dysfunction are needed.
  • This unified view could refine understanding, diagnosis, and treatment of heart failure.

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