Diastolic Heart Failure:Recent Concepts

Diastolic dysfunction (DD) of left ventricle as a cause of heart failure in presence of normal or near normal systolic function expressed as ejection fraction (EF) is a relatively recent concept. Understanding the physiology of diastolic function and development of echocardiographic technology and identification of highly sensitive biomarkers has made non-invasive recognition of diastolic heart failure in individual patients easier. It is now estimated that half of the patients having symptoms of heart failure have normal or near normal systolic function in whom diastolic dysfunction remains the cause of heart failure. Ageing, hypertension, ischaemic heart disease, diabetes, obesity and obstructive sleep apnoea are the leading causes of DD. Pharmacological treatment of diastolic heart failure is not well established. Treatment of comorbid conditions remains the mainstay of treatment. It has similar morbidity and mortality compared to heart failure with reduced EF.