Heart failure with preserved EF: a bird eye view.

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.