Diastolic heart failure (DHF) is estimated to occur in 40% to 50% of patients with
heart failure. Evidence suggests that DHF is primarily a cardiogeriatric syndrome
that increases from approximately 1% at age 50 years to 10% or more at 80 years. DHF
is also more likely to occur in older women who are hypertensive or diabetic. Although
survival is better in patients with DHF compared with systolic heart failure, mortality
rates for patients with DHF are four times higher than those for healthy, community-dwelling
older adults. The increase in DHF is anticipated to continue during the next several
decades largely because of the aging of the population; increase in risk factors associated
with hypertension, diabetes, and obesity; and ongoing technologic advances in the
treatment of cardiovascular disease. Few clinical trials have evaluated therapy in
this population, so evidence about the effectiveness of treatment strategies for DHF
is limited. Future research should target novel interventions that specifically target
patients with DHF who are typically older and female, and experience exertional intolerance
and have a considerably reduced quality of life.
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References
- Epidemiology of heart failure.Cardiol Clin. 2001; 19: 547-555
- Diastolic heart failure in the elderly.Heart Fail Rev. 2002; 7: 17-27
- Association of diastolic dysfunction and outcomes in ambulatory older adults with chronic heart failure.J Am Geriatr Soc. 2005; 60A: 1339-1344
- The epidemiology enigma of heart failure with preserved systolic function.Eur J Heart Fail. 2004; 6: 125-136
- Epidemiology, pathophysiology, prognosis, and treatment of systolic and diastolic heart failure.Cardiol Rev. 2006; 14: 108-124
- Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic.JAMA. 2003; 289: 194-202
- Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction.J Am Coll Cardiol. 1999; 33: 1948-1955
- Heart failure in older adults.Med Clin North Am. 2006; 90: 863-885
- Importance of heart failure with preserved systolic function in patients > 65 years of age.Am J Cardiol. 2001; 87: 413-419
- Predictors of congestive heart failure in the elderly: the cardiovascular health study.J Am Coll Cardiol. 2000; 35: 1628-1637
- Clinical characteristics and long-term outcomes of patients with heart failure and preserved systolic function.Am J Cardiol. 2000; 86: 863-867
- Risk factors for congestive heart failure in US men and women.Arch Intern Med. 2001; 161: 996-1002
- Outcomes in heart failure patients with preserved ejection fraction: mortality, readmission, and functional decline.J Am Coll Cardiol. 2003; 41: 1510-1518
- Therapy for diastolic heart failure.Prog Cardiovasc Dis. 2005; 47: 380-388
- Heart failure: adaptive and maladaptive processes.Circulation. 1993; 87 (VII-1-3)
- Diastolic heart failure: definitions and terminology.Prog Cardiovasc Dis. 2005; 47: 307-313
- New concepts in diastolic dysfunction and diastolic heart failure: Part I.Circulation. 2002; 105: 1387-1398
- Left atrial volume, geometry, and function in systolic and diastolic heart failure of persons > or = 65 years of age (the cardiovascular health study).Am J Cardiol. 2006; 97: 83-89
- New concepts in diastolic dysfunction and diastolic heart failure Part II: causal mechanisms and treatment.Circulation. 2002; 105: 1503-1508
- Left ventricular diastolic dysfunction and diastolic heart failure.Annu Rev Med. 2004; 55: 373-394
- Heart failure in the elderly: systolic and diastolic dysfunction.Am J Geriatr Cardiol. 1996; 5: 2026
- Defining diastolic heart failure: a call for standardized diagnostic criteria.Circulation. 2000; 101: 2118-2121
- Systolic and diastolic heart failure are associated with different plasma levels of B-type natriuretic peptide.Int J Clin Pract. 2005; 59: 891-894
- B-type natriuretic peptide strongly reflects diastolic wall stress in patients with chronic heart failure: comparison between systolic and diastolic heart failure.J Am Coll Cardiol. 2006; 47: 742-748
- The natural history of congestive heart failure: the Framingham study.N Engl J Med. 1971; 285: 1441-1446
- The epidemiology of heart failure: the Framingham Study.J Am Coll Cardiol. 1993; 22: 6A-13A
- Congestive heart failure in the community: a study of all incident cases in Olmstead County, Minnesota, in 1991.Circulation. 1998; 98: 2282-2289
- Congestive heart failure despite normal left ventricular systolic function in a population based sample: The Strong Heart Study.Am J Cardiol. 2000; 86: 1090-1096
- Confirmation of a heart failure epidemic: findings from the Resource Utilization Among Congestive Heart Failure (REACH) Study.J Am Coll Cardiol. 2002; 39: 60-69
- Clinical features and contemporary management of patients with low and preserved ejection fraction heart failure: baseline characteristics of patients in the Candesartan in Heart failure-Assessment of Reduction in Mortality and morbidity (CHARM) programme.Eur J Heart Fail. 2003; 5: 261-270
- Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial.Lancet. 2003; 362: 777-781
- Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trial.Lancet. 2003; 362: 772-776
- Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function taking angiotensin-converting-enzyme inhibitors: the CHARM-Added trial.Lancet. 2003; 362: 767-771
- The Irbesartan in heart failure with preserved systolic function (I-PRESERVE) trial: rationale and design.J Card Fail. 2005; 11: 576-585
- Higher New York Heart Association classes and increased mortality and hospitalization in patients with heart failure and preserved left ventricular function.Am Heart J. 2006; 151: 444-450
- Clinical features and prognosis associated with a preserved left ventricular systolic function in a large cohort of congestive heart failure outpatients managed by cardiologists.Ital Heart J. 2002; 3: 656-664
- Survival of elderly men with congestive heart failure.Age Ageing. 1992; 21: 49-55
- Correlates and outcomes of preserved left ventricular systolic function among older adults hospitalized with heart failure.Am Heart J. 2002; 144: 365-372
- Prognosis of congestive heart failure in elderly patients with normal versus abnormal left ventricular systolic function associated with coronary artery disease.Am J Cardiol. 1990; 66: 1257-1259
- Racial differences in the outcomes of patients with diastolic heart failure.Am Heart J. 2004; 148: 151-156
- State of disparities in cardiovascular health in the United States.Circulation. 2004; 111: 1233-1241
- Age-associated cardiovascular changes in health: impact on cardiovascular disease in older persons.Heart Fail Rev. 2002; 7: 29-49
- Left ventricular hypertrophy in patients with hypertension: importance of blood pressure response to regularly recurring stress.Circulation. 1983; 68: 470-476
- Lack of correlation between clinic and 24 hour ambulatory blood pressure in subjects participating in a therapeutic drug trial.J Clin Epidemiol. 1989; 42: 1049-1054
- From left ventricular hypertrophy to congestive heart failure: management of hypertensive heart disease.Prog Cardiovasc Dis. 2006; 48: 326-341
- Diastolic dysfunction in hypertensive heart disease is associated with altered myocardial metabolism.Circulation. 1999; 99: 2261-2267
- Left ventricular diastolic dysfunction as a cause of congestive heart failure.Ann Intern Med. 1992; 117: 502-510
- Afterload induced changes in myocardial relaxation: a mechanism for diastolic dysfunction.Cardiovasc Res. 1999; 43: 344-353
- Autocrine release of angiotensin II mediates stretch-induced hypertrophy of cardiac myocytes in vitro.Cell. 1993; 75: 977-984
- Intracellular signaling and genetic reprogramming during agonist-induced hypertrophy of cardiomyocytes.Ann N Y Acad Sci. 1995; 752: 343-352
- Glycemic control and heart failure among adult patients with diabetes.Circulation. 2001; 103: 2668-2673
- The myocardial and vascular pathology of diabetic cardiomyopathy.Coron Artery Dis. 1996; 7: 99-108
- Alterations in left ventricular structure and function in young healthy obese women: assessment by echocardiography and tissue Doppler imaging.J Am Coll Cardiol. 2004; 43: 1399-1404
- Role of diabetes in congestive heart failure: the Framingham study.Am J Cardiol. 1974; 34: 29-34
- Prevalence of diastolic dysfunction in normotensive, asymptomatic patients with well-controlled type 2 diabetes mellitus.Am J Cardiol. 2001; 87: 320-323
- Association of albuminuria with systolic and diastolic left ventricular dysfunction in type 2 diabetes: the Strong Heart Study.J Am Coll Cardiol. 2003; 41: 2022-2028
- Noncardiac comorbidity increases preventable hospitalizations and mortality among Medicare beneficiaries with chronic heart failure.J Am Coll Cardiol. 2003; 42: 1226-1233
- Heart failure in frail elderly patients: diagnostic difficulties, co-morbidities, polypharmacy and treatment dilemmas.Eur J Heart Fail. 2002; 4: 91-98
- Diastolic dysfunction.Crit Care Nurs Clin N Am. 2003; 15: 495-500
- Heart failure with preserved LV function: pathophysiology, clinical presentation, treatment, and nursing implications.J Cardiovasc Nurs. 2000; 14: 24-37
- Exercise intolerance.Prog Cardiovas Dis. 2005; 47: 367-379
- Diastolic dysfunction as a cause of exercise intolerance.Heart Fail Rev. 2000; 5: 301-306
- Exercise responses of elderly patients with diastolic versus systolic heart failure.Med Sci Sports Exerc. 2003; 35: 1477-1485
- Assessment of diastolic dysfunction.Prog Cardiovasc Dis. 2005; 47: 340-355
- Atrioventricular filling dynamics, diastolic dysfunction and dysfunction.Heart Fail Rev. 2000; 5: 291-299
- Management of diastolic heart failure—a practical review of pathophysiology and treatment trial data.Int J Clin Pract. 2005; 59: 1239-1246
- Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic aspects.Cardiovasc Ultrasound. 2005; 3: 9
- A review of the current evidence for the use of angiotensin-receptor blockers in chronic heart failure.Int J Clin Pract. 2005; 59: 571-578
- Executive summary: HFSA 2006 Comprehensive Heart Failure Practice Guideline.J Card Fail. 2006; 12: 10-38
- Diastolic dysfunction and function: diastolic dysfunction in the elderly: Genesis and diagnostic and therapeutic implications.Cardiol Clin. 2000; 18: 1-28
- Neurohormonal pathways in heart failure with preserved systolic function.Prog Cardiovasc Dis. 2005; 47: 357-366
- Angiotensin-converting enzyme inhibitors and angiotensin II type I receptor blockers in the management of congestive heart failure patients: what have we learned from recent clinical trials?.Curr Opin Cardiol. 2005; 20: 250-255
- ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure).J Am Coll Cardiol. 2001; 38: 2101-2113
- Losartan improves exercise tolerance in patients with diastolic dysfunction and a hypertensive response to exercise.J Am Coll Cardiol. 1999; 33: 1567-1572
- Effect of losartan and hydrochlorothiazide on exercise tolerance in exertional hypertension and left ventricular diastolic dysfunction.Am J Cardiol. 2006; 98: 383-385
- Aldosterone receptor antagonists for heart failure: current status, future indications.Cleve Clin J Med. 2006; 73: 257-268
- Digoxin and reduction in mortality and hospitalization in heart failure: a comprehensive post hoc analysis of the DIG trial.Eur Heart J. 2006; 27: 178-186
- Predictors of mortality in patients with heart failure and preserved systolic function in the Digitalis Investigation Group trial.J Am Coll Cardiol. 2004; 44: 1025-1029
- Exercise and heart failure: a statement from the American Heart Association Committee on exercise, rehabilitation and prevention.Circulation. 2003; 107: 1210-1225
- Cardiac rehabilitation in older coronary patients.J Am Geriatr Soc. 1999; 47: 98-105
- Home-based exercise improves functional performance and quality of life in women with diastolic heart failure.Heart Lung. 2004; 33: 210-218
- Psychophysical bases of perceived exertion.Med Sci Sports Exerc. 1982; 14: 377-381
- Exercise self-efficacy in older women with diastolic heart failure: results of a walking program and education intervention.J Gerontol Nurs. 2006; 32: 31-39
- Managing congestive heart failure using home telehealth.Home Healthc Nurse. 2004; 22: 19-22
- Predictors of a sustained response to exercise training in patients with chronic heart failure: a telemonitoring study.Am Heart J. 2005; 150: 1240-1247
- Family education and support interventions in heart failure: a pilot study.Nurs Res. 2005; 54: 158-166
- What do patients know about their heart failure?.Appl Nurs Res. 2002; 15: 200-208
- Self-care abilities of patients with heart failure.Heart Lung. 2001; 30: 351-359
- Depression, physical impairment, and treatment of depression in chronic heart failure.J Cardiovasc Nurs. 2006; 21: 178-185
- Depression outcome in inpatients with congestive heart failure.Arch Intern Med. 2006; 166: 991-996
- Why is depression bad for the failing heart?.J Card Fail. 2004; 10: 258-271
- Depression and anxiety in heart failure.J Card Fail. 2005; 11: 455-463
- Prognostic importance of emotional support for elderly patients hospitalized with heart failure.Circulation. 1998; 97: 958-964
- The Brief Symptom Inventory: an introductory report.Psychol Med. 1983; 13: 595-605
- Mortality benefit of a comprehensive heart failure disease management program in indigent patients.Am Heart J. 2006; 151: 478-483
- Home-based intervention in congestive heart failure: long term implications on readmission and survival.Circulation. 2002; 105: 2861-2866
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