Interní Med. 2005; 7(12): 527-532

What a physician should know about diastolic heart failure?

prof. MUDr. Jindřich Špinar CSc., FESC, prof. MUDr. Jiří Vítovec CSc., FESC

I. interní kardioangiologická klinika FN u sv. Anny v Brně

Epidemiological studies show that 30-50% of all patients with chronic heart failure have normal ejection fraction of the left ventricle. Mostly in these patients, the primary cause of heart failure is a diastolic dysfunction of left ventricle. According to the definition of European Cardiologic Society, three criteria must be fulfilled for diagnosis of diastolic heart failure: (1) signs of heart failure; (2) preserved left ventricular systolic function (EF > 0,45); objective proof of abnormal relaxation, distensibility or filling of left ventricle. The prevalence of a diastolic heart failure increases with age. It affect women more frequently (approx. 60%), less patients after myocardial infarction (approx. 20%) and is more accompanied by hypertension compared to systolic heart failure. The prognosis of patients with diastolic heart failure seems to be better compared with systolic heart failure. The mortality is lower by approximately 30%.

Several smaller clinical studies were finished, which show increased load tolerance after a verapamil, beta-blockers, ACE inhibitors and AII antagonists. The first two mortality clinical studies – CHARM Preserved with candesartan and SENIORS with nebivolol showed a decrease in number of admissions, there is only a trend for improvement in mortality. The mainstay of treatment are still a good control of hypertension and pulse. The main medication groups are beta-blockers, ACE inhibitors and AII antagonists.

Keywords: Key words: diastolic failure, beta-blockers, ACE inhibitors, AII antagonists, hypertension.

Published: January 1, 2006  Show citation