Update on diastolic heart failure or heart failure with preserved ejection fraction in the older adults
- 20 October 2011
- journal article
- review article
- Published by Taylor & Francis in Annals of Medicine
- Vol. 45 (1), 37-50
- https://doi.org/10.3109/07853890.2012.660493
Abstract
Nearly half of all heart failure (HF) patients have diastolic HF (DHF) or clinical HF with normal or near-normal left ventricular ejection fraction (LVEF). Although the terminology has not been clearly defined, it is increasingly being referred to as HF with preserved ejection fraction (HFPEF). The prevalence of HFPEF increases with age, especially among older women. Identifying HFPEF is important because the etiology, pathogenesis, prognosis, and optimal management may differ from that for systolic HF (SHF) or HF with reduced ejection fraction. The clinical presentation of HF is similar for both SHF and HFPEF. As in SHF, HFPEF is a clinical diagnosis. Once a clinical diagnosis of HF has been made, the presence of HFPEF can be established by confirming a normal or near-normal LVEF, often by an echocardiogram. HFPEF is often associated with a history of hypertension, concentric left ventricular hypertrophy, vascular stiffness, and left ventricular diastolic dysfunction. As in SHF, HFPEF is also associated with poor outcomes. While therapies with angiotensin-converting enzyme inhibitors and beta-blockers improve outcomes in SHF, there is currently no such evidence of their benefits in older HFPEF patients. In this review recent advances in the diagnosis and management of HFPEF in older adults are discussed.Keywords
This publication has 97 references indexed in Scilit:
- A comparison of echocardiographic measures of diastolic function for predicting all-cause mortality in a predominantly male populationAmerican Heart Journal, 2011
- Relation of Baseline Systolic Blood Pressure and Long-Term Outcomes in Ambulatory Patients With Chronic Mild to Moderate Heart FailureThe American Journal of Cardiology, 2011
- Global Cardiovascular Reserve Dysfunction in Heart Failure With Preserved Ejection FractionJournal of the American College of Cardiology, 2010
- Gender-related dissociation in outcomes in chronic heart failure: Reduced mortality but similar hospitalization in womenInternational Journal of Cardiology, 2009
- Contractility and Ventricular Systolic Stiffening in Hypertensive Heart DiseaseJournal of the American College of Cardiology, 2009
- Prognostic Value of Left Ventricular End-Systolic Volume Index as a Predictor of Heart Failure Hospitalization in Stable Coronary Artery Disease: Data from the Heart and Soul StudyJournal of the American Society of Echocardiography, 2008
- Ethnicity and Left Ventricular Diastolic Function in Hypertension: An ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) SubstudyJournal of the American College of Cardiology, 2008
- Ventricular–Vascular Interaction in Heart FailureHeart Failure Clinics, 2008
- Prevalence and Prognosis of Asymptomatic Left Ventricular Diastolic Dysfunction in Ambulatory Patients With Coronary Heart DiseaseThe American Journal of Cardiology, 2007
- Hospitalizations Due to Unstable Angina Pectoris in Diastolic and Systolic Heart FailureThe American Journal of Cardiology, 2006