Simple and Practical Way of Assessing Diastolic Function: Diastolic Heart Failure Revisited.

Abstract

Recently, usage of the term 'heart failure with preserved ejection fraction (HFpEF)' has predominated over the term 'diastolic heart failure (DHF).' The term 'preserved ejection fraction' represents only one aspect of DHF and does not provide insight into the hemodynamic mechanism of heart failure. In heart failure with reduced ejection fraction (HFrEF), depressed ejection fraction is the independent determinant of prognosis regardless of etiology. However, in HFpEF, because the prognosis is predominantly determined by etiologies of HFpEF, results of the drug on the prognosis in the clinical trial cannot be interpreted as it is. Therefore, studies on patients with HFpEF should be restricted to patients with diastolic dysfunction and, effects of drugs should be focused on symptom improvement not survival benefit. One reason for the prevalent use of HFpEF over DHF is the complexity in assessing diastolic function. Current official recommendations for the evaluation of diastolic function are too complex to be widely applied in the patient enrollment in large clinical trials as well as not easily applicable in our daily clinical practice. Therefore, there is a clinical need for a simple and practical way of assessing diastolic function.