Abstract
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.
References
Dec 1, 1995·The American Journal of Medicine·M M McDermottM Gheorghiade
Dec 24, 1997·European Heart Journal·F Rodríguez-ArtalejoJ del Rey Calero
Aug 26, 1998·European Heart Journal
Nov 24, 1998·Circulation·M SenniM M Redfield
May 3, 2000·Circulation·R S Vasan, D Levy
Sep 7, 2000·Circulation·K MacIntyreJ J McMurray
Aug 15, 2001·Circulation·M R ZileP R Liebson
Feb 6, 2002·Circulation·Emily LubienAlan S Maisel
Feb 9, 2002·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Sharon A HuntUNKNOWN American Heart Association
Mar 20, 2002·Circulation·Michael R Zile, Dirk L Brutsaert
Mar 27, 2002·Circulation·Michael R Zile, Dirk L Brutsaert
Jan 16, 2003·Heart·M BayJ Aldershvile
Aug 2, 2003·Lancet·James A de LemosMark H Drazner
Sep 19, 2003·Lancet·Salim YusufUNKNOWN CHARM Investigators and Committees
Nov 14, 2003·European Heart Journal·Manuel Martínez-SellésJesus Almendral