Document Detail


Diastolic heart failure: challenges of diagnosis and treatment.
MedLine Citation:
PMID:  15202695     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Diastolic heart failure, a major cause of morbidity and mortality, is defined as symptoms of heart failure in a patient with preserved left ventricular function. It is characterized by a stiff left ventricle with decreased compliance and impaired relaxation, which leads to increased end diastolic pressure. Signs and symptoms are similar to those of heart failure with systolic dysfunction. The diagnosis of diastolic heart failure is best made with Doppler echocardiography. Based on current knowledge, pharmacologic treatment of diastolic heart failure should focus on normalizing blood pressure, promoting regression of left ventricular hypertrophy, avoiding tachycardia, treating symptoms of congestion, and maintaining normal atrial contraction when possible. Diuretic therapy is the mainstay of treatment for preventing pulmonary congestion, while beta blockers appear to be useful in preventing tachycardia and thereby prolonging left ventricular diastolic filling time. Angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers may be beneficial in patients with diastolic dysfunction, especially those with hypertension. Evidence from adequately powered randomized controlled trials, however, is not available yet. The outcomes of ongoing clinical trials may provide much-needed information to move from intuitive treatment to therapy based on evidence that matters: decreased morbidity and mortality and improved quality of life.
Authors:
Cecilia Gutierrez; Daniel G Blanchard
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American family physician     Volume:  69     ISSN:  0002-838X     ISO Abbreviation:  Am Fam Physician     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-18     Completed Date:  2004-07-13     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  1272646     Medline TA:  Am Fam Physician     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2609-16     Citation Subset:  AIM; IM    
Affiliation:
Department of Family Medicine and Preventive Medicine, University of California, San Diego, School of Medicine, La Jolla, California 92093, USA. cagutierrez@ucsd.edu
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Cardiac Output, Low* / diagnosis,  physiopathology,  therapy
Diastole
Echocardiography, Doppler
Humans
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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