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Updated: May 4, 2026
Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
Heart failure with preserved EF: a bird eye view
Fahad Aziz1, Luqman-Arfath Thazhatauveetil-Kunhahamed1, Chijioke Enweluzo1
1Wake Forest School of Medicine, 295 Chelsea Village Cir, Winston Salem, NC 27103, USA.
Insights
Diastolic heart failure, characterized by preserved ejection fraction, affects elderly patients with hypertension. Early recognition and treatment of diastolic dysfunction are crucial to prevent progression and improve outcomes.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Diastolic heart failure (DHF) is recognized in patients with heart failure symptoms but normal left ventricular ejection fraction.
- This condition was historically attributed to impaired diastolic function, despite unclear origins of this assumption.
- Diagnostic guidelines for DHF have been established, often utilizing Doppler echocardiography indicators of diastolic dysfunction.
Purpose of the Study:
- To summarize the understanding and clinical implications of diastolic heart failure.
- To highlight the importance of early recognition and management of diastolic dysfunction.
Main Methods:
- Review of the concept and clinical presentation of diastolic heart failure.
- Analysis of mortality and morbidity rates in comparison to systolic heart failure.
- Discussion of current therapeutic approaches and evidence for pharmacological interventions.
Main Results:
- Diastolic heart failure has a lower annual mortality rate (approx. 8%) compared to systolic heart failure (19%), but significant morbidity.
- The condition is predominantly observed in elderly individuals with hypertensive heart disease.
- No direct therapies exist to improve left ventricular diastolic function; treatment focuses on underlying conditions.
Conclusions:
- Early identification and management of diastolic dysfunction are vital to prevent progression to DHF and reduce mortality.
- While specific therapies for diastolic dysfunction are lacking, certain medications (calcium channel blockers, beta-blockers, ACE inhibitors, ARBs, nitric oxide donors) may offer benefits.
- Treating the underlying causes, such as hypertension, remains the cornerstone of managing diastolic heart failure.
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.
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