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Update in the management of diastolic heart failure.
Curr Vasc Pharmacol 2004; 2(3):301-8CV

Abstract

Diastolic heart failure (DHF) is characterized by the clinical presentation of heart failure in the setting of preserved left ventricular systolic function and evidence of diastolic dysfunction. It is estimated to be present in at least one-third of patients, who represent the signs and symptoms of heart failure, and is especially prevalent among the elderly population. Despite an increasing understanding of the pathophysiology of this disease and the improvement of diagnostic and prognostic assessment, the management of DHF remains to be established. Medical therapy consists of the cautious use of diuretics, and some studies suggested the beneficial role of beta-blockers and calcium antagonists. The rationale of current therapy is largely dependent on understanding the pathophysiology of DHF and observations from clinical trials that included relatively small numbers of patients. Large, multicenter, randomized, controlled studies are needed to define the role of various therapeutic agents in DHF, and whether the prognosis of the disease will be altered. The SWEDIC trial observed that carvedilol treatment in patients with DHF was associated with an improvement in diastolic indices measured by Doppler echocardiography. The CHARM-Preserved trial reported a non-significant reduction of cardiovascular death or admission for heart failure. Other studies which are underway include PEP-CHF and the Hong Kong Diastolic Heart Failure study. They will play a pivotal role in ascertaining the therapeutic efficacy of various agents and will help experts to set up treatment guidelines for this common condition.

Authors+Show Affiliations

Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong. cmyu@cuhk.edu.hkNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15320827

Citation

Yu, Cheuk-Man, and John E. Sanderson. "Update in the Management of Diastolic Heart Failure." Current Vascular Pharmacology, vol. 2, no. 3, 2004, pp. 301-8.
Yu CM, Sanderson JE. Update in the management of diastolic heart failure. Curr Vasc Pharmacol. 2004;2(3):301-8.
Yu, C. M., & Sanderson, J. E. (2004). Update in the management of diastolic heart failure. Current Vascular Pharmacology, 2(3), pp. 301-8.
Yu CM, Sanderson JE. Update in the Management of Diastolic Heart Failure. Curr Vasc Pharmacol. 2004;2(3):301-8. PubMed PMID: 15320827.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Update in the management of diastolic heart failure. AU - Yu,Cheuk-Man, AU - Sanderson,John E, PY - 2004/8/24/pubmed PY - 2006/7/6/medline PY - 2004/8/24/entrez SP - 301 EP - 8 JF - Current vascular pharmacology JO - Curr Vasc Pharmacol VL - 2 IS - 3 N2 - Diastolic heart failure (DHF) is characterized by the clinical presentation of heart failure in the setting of preserved left ventricular systolic function and evidence of diastolic dysfunction. It is estimated to be present in at least one-third of patients, who represent the signs and symptoms of heart failure, and is especially prevalent among the elderly population. Despite an increasing understanding of the pathophysiology of this disease and the improvement of diagnostic and prognostic assessment, the management of DHF remains to be established. Medical therapy consists of the cautious use of diuretics, and some studies suggested the beneficial role of beta-blockers and calcium antagonists. The rationale of current therapy is largely dependent on understanding the pathophysiology of DHF and observations from clinical trials that included relatively small numbers of patients. Large, multicenter, randomized, controlled studies are needed to define the role of various therapeutic agents in DHF, and whether the prognosis of the disease will be altered. The SWEDIC trial observed that carvedilol treatment in patients with DHF was associated with an improvement in diastolic indices measured by Doppler echocardiography. The CHARM-Preserved trial reported a non-significant reduction of cardiovascular death or admission for heart failure. Other studies which are underway include PEP-CHF and the Hong Kong Diastolic Heart Failure study. They will play a pivotal role in ascertaining the therapeutic efficacy of various agents and will help experts to set up treatment guidelines for this common condition. SN - 1570-1611 UR - https://www.unboundmedicine.com/medline/citation/15320827/Update_in_the_management_of_diastolic_heart_failure_ L2 - http://www.eurekaselect.com/80464/article DB - PRIME DP - Unbound Medicine ER -