Diastolic Dysfunction

Although the annual mortality rate for diastolic heart failure is better than that for systolic heart failure, it is still greater than that for age-matched controls. Five-year mortality rates are about 50% for patients with systolic heart failure and are about 25% for patients with diastolic heart failure. In elderly patients (over 65 years of age), the outcome with systolic and diastolic dysfunction may be more comparable. In contrast to systolic heart failure, the effect of therapy in patients with diastolic heart failure has not been evaluated in large clinical controlled trials. Guidelines for managing heart failure with preserved systolic function broadly suggest the direction for management, but specific treatments are currently based on expert consensus, clinical experience, and scientific elucidation of diastolic mechanics. Although evidence-based guidelines are not available for all aspects of management of diastolic heart failure, future research will increase the knowledge of this disorder and improve treatment strategies.