Diastolic heart failure. Diagnosis, prognosis, treatment.

It is now abundantly clear that congestive heart failure caused by a predominant abnormality in diastolic function (i.e., diastolic heart failure) is common and causes a significant increase in morbidity and mortality. However, there is continued controversy surrounding the terminology used to describe patients with heart failure and the criteria used to make the diagnosis of diastolic heart failure. As a result, clinical therapeutic trials have been slow to develop and difficult to design. Fortunately, these controversies are yielding to an emerging consensus. Recent clinical studies have provided sufficient data to develop standardized diagnostic criteria to define diastolic heart failure. Experimental studies have provided increased insight into the mechanisms causing diastolic heart failure. Together, these clinical and experimental studies are being used to design targeted clinical trials to test effective treatments for diastolic heart failure. The purpose of this review is to describe the criteria used to diagnose diastolic heart failure, the effects of diastolic heart failure on prognosis, and approaches to treatment.