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Updated: Mar 9, 2026

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
Deliberations on Diastolic Heart Failure
1Department of Cardiovascular Medicine, Lahey Hospital and Medical Center, Burlington, Massachusetts; Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts.
Insights
Diastolic heart failure (DHF) is a distinct subgroup within heart failure with preserved ejection fraction. Further research and clinical trials should focus on specific DHF phenotypes for targeted therapies.
Area of Science:
- Cardiology
- Heart Failure Research
Background:
- Left ventricular diastolic dysfunction and diastolic heart failure (DHF) have been extensively studied over the past four decades.
- Existing research indicates DHF patients are a subgroup within the broader category of heart failure with preserved ejection fraction (HFpEF).
Purpose of the Study:
- To review historical and recent literature on diastolic heart failure.
- To advocate for targeted clinical investigations and therapeutic trials within specific DHF subgroups.
- To emphasize the need for clear diagnostic criteria for DHF and focus on distinct patient phenotypes.
Main Methods:
- Literature review of studies on left ventricular diastolic dysfunction and diastolic heart failure.
- Analysis of historical and contemporary research findings.
- Synthesis of information to define DHF as a distinct entity within HFpEF.
Main Results:
- Diastolic heart failure (DHF) represents a specific subgroup within the heterogeneous population of patients diagnosed with heart failure with preserved ejection fraction (HFpEF).
- Current broad approaches to HFpEF may not be optimal for DHF patients.
Conclusions:
- Clinical trials and investigations for heart failure should be precisely targeted at specific patient subgroups, not the general HFpEF population.
- Establishing clear diagnostic criteria for DHF is crucial.
- Focusing research on specific DHF phenotypes will enhance the development of effective, targeted therapies.
Abstract:
Studies of left ventricular diastolic dysfunction and diastolic heart failure (DHF), published during the past 4 decades, include a prodigious number and wide variety of research efforts. This review report considers some of the historical literature and incorporates more recent information supporting the idea that patients with DHF constitute a subgroup of the heterogeneous population of patients with heart failure and a preserved ejection fraction. Clinical investigation, particularly therapeutic trials, should be directed at specific targets within the population of interest, not at the broad heart failure with preserved ejection fraction population. To accomplish this, it is important to stipulate criteria for the diagnosis of DHF and to limit our attention to specific subgroups or phenotypes.
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