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Diastolic dysfunction: a link between hypertension and heart failure.
Drugs Today (Barc). 2008 Jul; 44(7):503-13.DT

Abstract

Diastolic heart failure is characterized by the symptoms and signs of heart failure, a preserved ejection fraction and abnormal left ventricular (LV) diastolic function caused by a decreased LV compliance and relaxation. The signs and symptoms of diastolic heart failure are indistinguishable from those of heart failure related to systolic dysfunction; therefore, the diagnosis of diastolic heart failure is often one of exclusion. The majority of patients with heart failure and preserved ejection fraction have a history of hypertension. Hypertension induces a compensatory thickening of the ventricular wall in an attempt to normalize wall stress, which results in LV concentric hypertrophy, which in turn decreases LV compliance and LV diastolic filling. There is an abnormal accumulation of fibrillar collagen accompanying the hypertension-induced LV hypertrophy, which is also associated with decreased compliance and LV diastolic dysfunction. There are no specific guidelines for treating diastolic heart failure, but pharmacological treatment should be directed at normalizing blood pressure, promoting regression of LV hypertrophy, preventing tachycardia and treating symptoms of congestion. Preventive strategies directed toward an early and aggressive blood pressure control are likely to offer the greatest promise for reducing the incidence of diastolic heart failure.

Authors+Show Affiliations

Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.No affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Review

Language

eng

PubMed ID

18806901

Citation

Lalande, Sophie, and Bruce D. Johnson. "Diastolic Dysfunction: a Link Between Hypertension and Heart Failure." Drugs of Today (Barcelona, Spain : 1998), vol. 44, no. 7, 2008, pp. 503-13.
Lalande S, Johnson BD. Diastolic dysfunction: a link between hypertension and heart failure. Drugs Today. 2008;44(7):503-13.
Lalande, S., & Johnson, B. D. (2008). Diastolic dysfunction: a link between hypertension and heart failure. Drugs of Today (Barcelona, Spain : 1998), 44(7), 503-13. https://doi.org/10.1358/dot.2008.44.7.1221662
Lalande S, Johnson BD. Diastolic Dysfunction: a Link Between Hypertension and Heart Failure. Drugs Today. 2008;44(7):503-13. PubMed PMID: 18806901.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diastolic dysfunction: a link between hypertension and heart failure. AU - Lalande,Sophie, AU - Johnson,Bruce D, PY - 2008/9/23/pubmed PY - 2008/10/22/medline PY - 2008/9/23/entrez SP - 503 EP - 13 JF - Drugs of today (Barcelona, Spain : 1998) JO - Drugs Today VL - 44 IS - 7 N2 - Diastolic heart failure is characterized by the symptoms and signs of heart failure, a preserved ejection fraction and abnormal left ventricular (LV) diastolic function caused by a decreased LV compliance and relaxation. The signs and symptoms of diastolic heart failure are indistinguishable from those of heart failure related to systolic dysfunction; therefore, the diagnosis of diastolic heart failure is often one of exclusion. The majority of patients with heart failure and preserved ejection fraction have a history of hypertension. Hypertension induces a compensatory thickening of the ventricular wall in an attempt to normalize wall stress, which results in LV concentric hypertrophy, which in turn decreases LV compliance and LV diastolic filling. There is an abnormal accumulation of fibrillar collagen accompanying the hypertension-induced LV hypertrophy, which is also associated with decreased compliance and LV diastolic dysfunction. There are no specific guidelines for treating diastolic heart failure, but pharmacological treatment should be directed at normalizing blood pressure, promoting regression of LV hypertrophy, preventing tachycardia and treating symptoms of congestion. Preventive strategies directed toward an early and aggressive blood pressure control are likely to offer the greatest promise for reducing the incidence of diastolic heart failure. SN - 1699-3993 UR - https://www.unboundmedicine.com/medline/citation/18806901/Diastolic_dysfunction:_a_link_between_hypertension_and_heart_failure_ L2 - http://journals.prous.com/journals/servlet/xmlxsl/pk_journals.xml_summaryn_pr?p_JournalId=4&p_RefId=1221662 DB - PRIME DP - Unbound Medicine ER -