Peer Reviewed
Feature Article Cardiovascular medicine
Diastolic heart failure: a clinical update
Abstract
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.
Key Points
- 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.
Purchase the PDF version of this article
Already a subscriber? Login here.