Heart failure with preserved ejection fraction: refocusing on diastole.

Authors :: Abbate A
Arena R
Abouzaki N
Van Tassell BW
Canada J
Shah K
Biondi-Zoccai G
Voelkel NF
Source :: International journal of cardiology [Int J Cardiol] 2015 Jan 20; Vol. 179, pp. 430-40. Date of Electronic Publication: 2014 Nov 14.
Publication Year :: 2015
Abstract: Heart failure (HF) with preserved ejection fraction (HFpEF) is a clinical syndrome of exercise intolerance and/or congestion, in the presence of a left ventricular (LV) ejection fraction within the normal limits (i.e. LVEF>50%). Determining the presence of impaired LV relaxation and/or filling (diastolic dysfunction) in HFpEF is needed to pragmatically to distinguish it from other cardiac and non-cardiac conditions where symptoms are not due to HF. There are multiple mechanisms for diastolic dysfunction ranging from structural abnormalities to functional derangements in HFpEF yet tailored therapies are lacking. Treatments proven effective in HF with systolic dysfunction have failed to show significant benefit in patients with HFpEF, which prognosis remains poor. This review will discuss the challenges inherent to the use of diagnostic criteria for HFpEF, differential diagnosis, prognostic evaluation, and treatment, highlighting the need for more research in this field.<br /> (Copyright © 2014. Published by Elsevier Ireland Ltd.)