This Article Full Text Full Text (PDF) Data Supplement Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wang, J. Articles by Nagueh, S. F. Search for Related Content PubMed PubMed Citation Articles by Wang, J. Articles by Nagueh, S. F. Related Collections Congestive Hypertrophy Myocardial cardiomyopathy disease

(Circulation. 2009;119:1146-1157.)
© 2009 American Heart Association, Inc.

Contemporary Reviews in Cardiovascular Medicine

Current Perspectives on Cardiac Function in Patients With Diastolic Heart Failure

Jianwen Wang, MD, PhD; Sherif F. Nagueh, MD

From Methodist DeBakey Heart and Vascular Center, Houston, Tex.

Correspondence to Sherif F. Nagueh, MD, Methodist DeBakey Heart and Vascular Center, 6550 Fannin, SM 677, Houston, TX 77030. E-mail snagueh@tmhs.org

Key Words: diastole • heart failure • hemodynamics • ventricles

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Despite recent advances in the diagnosis and management of heart failure, the rate of hospitalizations for this condition is increasing. At least 50% of patients present with heart failure despite a normal ejection fraction (EF) and are referred to as having heart failure with normal EF or diastolic heart failure (DHF). Recently, a group of investigators met to address the issue of nomenclature and agreed that the term DHF is preferred but that it does not refute the presence of other abnormalities in this condition.¹ We therefore use this term throughout the present review.

There are several opinions about the pathophysiology of this condition that have been expressed passionately by many groups. They include issues pertaining to left ventricular (LV) systolic properties, ventricular arterial coupling, and last but not least, LV diastolic function. Recent studies that used novel imaging modalities and others that used conductance catheters in DHF patients have provided additional data that are pertinent to the ongoing debate and have potential therapeutic implications. However, before discussing the recent studies, it is important to comment on certain morphological characteristics in DHF patients that are distinct from those in patients with systolic heart failure. In particular, LV dimensions and volumes are normal in DHF patients,² whereas wall thickness and LV mass are increased, although the latter finding is not universal. In an exception to the above findings, a recent study³ reported that LV end-diastolic volumes were increased in DHF patients. However, a single M-mode measurement was used to convert LV . . . [Full Text of this Article]

This article has been cited by other articles:

				T. D. Karamitsos, J. M. Francis, S. Myerson, J. B. Selvanayagam, and S. Neubauer The Role of Cardiovascular Magnetic Resonance Imaging in Heart Failure J. Am. Coll. Cardiol., October 6, 2009; 54(15): 1407 - 1424. [Abstract] [Full Text] [PDF]

				W. C. Little and J. K. Oh Echocardiographic Evaluation of Diastolic Function Can Be Used to Guide Clinical Care Circulation, September 1, 2009; 120(9): 802 - 809. [Full Text] [PDF]

				C. Tschope and W. J. Paulus Doppler Echocardiography Yields Dubious Estimates of Left Ventricular Diastolic Pressures Circulation, September 1, 2009; 120(9): 810 - 820. [Full Text] [PDF]

				T. T. Phan, K. Abozguia, G. Nallur Shivu, G. Mahadevan, I. Ahmed, L. Williams, G. Dwivedi, K. Patel, P. Steendijk, H. Ashrafian, et al. Heart failure with preserved ejection fraction is characterized by dynamic impairment of active relaxation and contraction of the left ventricle on exercise and associated with myocardial energy deficiency. J. Am. Coll. Cardiol., July 28, 2009; 54(5): 402 - 409. [Abstract] [Full Text] [PDF]