Although the clinical syndrome of heart failure is usually secondary to impaired left ventricular contraction, a significant number of patients with this syndrome have isolated diastolic dysfunction. Systolic and diastolic heart failure may be clinically indistinguishable; the mainstays of establishing a diagnosis of diastolic heart failure are noninvasive techniques, such as echocardiography.
- Although systolic and diastolic dysfunction heart failure coexist, a significant number of patients have pure diastolic heart failure.
- Pure diastolic failure is characterised by congestive cardiac failure, normal or almost normal systolic function, and abnormal left ventricular relaxation, filling and/or stiffness.
- Echocardiography is a useful tool for diagnosing diastolic dysfunction, demonstrating its aetiology, and excluding systolic left ventricular dysfunction.
- Treatment of pure diastolic heart failure, although empirical, requires addressing potential reversible processes, such as hypertension, atrio-ventricular synchrony, and ischaemia.
- It is important that lifestyle measures are not overlooked. These include restricted salt intake, avoidance of alcohol, regular physical activity and pneumococcal and influenza vaccinations.