2003, Number 4
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Arch Cardiol Mex 2003; 73 (4)
Does diastolic heart failure exist?
JF Guadalajara Boo
Language: Spanish
References: 37
Page: 291-300
PDF size: 136.29 Kb.
ABSTRACT
This paper reviews the concepts of systolic function, diastolic function, heart
failure, diastolic dysfunction, and diastolic heart failure. We refer to the
historic evolution of the concept of heart failure and the origin of the term
diastolic heart failure. Based on the current concepts of the physiology of
the heart and its pathophysiology, we discuss the inappropriateness of the term
and to the confusion it has generated in clinical practice, treatment, and prognosis,
as well as in numerous research papers (of which some examples are given) when
terming as “heart failure” the diastolic dysfunction and using both
terms indistinctively. We conclude that an increasing need has arisen, ever
more imperative, to identify clearly the concepts of heart failure and diastolic
dysfunction, emphasizing on their differences to recognize them as distinct
clinical entities with their own personality and, hence, having different prognosis
and treatment. This would be of great help to achieve more accuracy in the clinical
guidelines, standards, and consensus, especially regarding treatment. Besides
it would be useful to avoid, inconsistencies in the design of research, which
appear in some of the publications just by the lack of a clear meaning of the
terms. Finally, at present we have the necessary elements to conclude that the
terms “diastolic heart failure” and “cardiac failure with preserved
systolic function” are inexact, poorly gauged, and far away from the actual
problem they try to define. Therefore, they should be substituted by the concept
of Diastolic Dysfunction, which defines clearly the pathophysiology of the functional
alteration, without having to state that “the heart is failing.
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