Diagnosis and Therapy for Diastolic Heart Failure
نویسندگان
چکیده
112 Diastolic heart failure (heart failure with preserved systolic function) causes 30% to 50% of all cases of heart failure, and its prognosis is almost as ominous as that of systolic heart failure. Currently, it is diagnosed when clinical criteria for heart failure are present and left ventricular ejection fraction is preserved (higher than 40% to 50%). However, determinations of brain natriuretic peptides may play an important role in the future. Because we have no evidence from clinical trials, with the exception of the slight benefit obtained with candesartan in reducing hospitalizations in the CHARM Study, treatment of diastolic heart failure is based on the identification and treatment of the causal factor (hypertension, coronary heart disease), control of heart rate, and relief of fluid congestion. Thus, combined therapy with low-dose diuretics, antihypertensive drugs for bradycardia (beta blockers, calcium antagonists) and angiotensin antagonists seems now to be the best therapeutic strategy.
منابع مشابه
Assessment of left ventricular diastolic function and recognition of diastolic heart failure.
Left ventricular (LV) diastolic dysfunction, as occurs in patients with hypertension, diabetes mellitus, and/or aging, carries a substantial risk of the subsequent development of heart failure and reduced survival, even when it is asymptomatic or “preclinical.”1–4 Diastolic dysfunction is defined as functional abnormalities that exist during LV relaxation and filling. When such abnormalities ca...
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