Simple and Practical Way of Assessing Diastolic Function: Diastolic Heart Failure Revisited

Area of Science:

• Cardiology
• Clinical Medicine

Background:

• The term 'heart failure with preserved ejection fraction' (HFpEF) is now more common than 'diastolic heart failure' (DHF).
• HFpEF focuses on ejection fraction, overlooking the hemodynamic mechanisms crucial for understanding diastolic heart failure.
• Prognosis in HFpEF is primarily linked to underlying etiologies, complicating drug trial interpretations focused on survival benefits.

Purpose of the Study:

• To highlight the limitations of the term HFpEF in fully capturing the essence of diastolic heart failure.
• To advocate for a shift in focus for HFpEF studies towards specific etiologies and symptom improvement rather than survival.
• To underscore the clinical need for a simplified and practical method for assessing diastolic function.

Main Methods:

• Comparative analysis of terminology and diagnostic implications in heart failure research.
• Review of current recommendations for evaluating diastolic function.
• Discussion of challenges in applying complex diagnostic criteria in clinical trials and practice.

Main Results:

• The term HFpEF inadequately represents the multifaceted nature of DHF.
• Current diastolic function assessment guidelines are too complex for widespread clinical trial enrollment and daily practice.
• The lack of simple assessment tools hinders effective research and patient management in DHF.

Conclusions:

• Research and drug trials in HFpEF should focus on patients with confirmed diastolic dysfunction and prioritize symptom improvement.
• There is a significant clinical need for developing and implementing simpler, practical methods for assessing diastolic function.
• Revisiting the terminology and diagnostic approaches for diastolic heart failure is essential for advancing patient care and research.