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Background  Little is known regarding the impact of diastolic function on cardiac output ( CO ) in patients with heart failure, particularly in patients with lower ejection fraction. This study aimed to evaluate the impact of end‐diastolic pressure–volume relationship ( EDPVR ) on  CO  and end‐diastolic pressure ( EDP ).    Methods and Results  We retrospectively analyzed 1840 consecutive patients who underwent heart catheterization. We divided patients into 8 groups according to ejection fraction ( EF ) (35–45%, 46–55%, 56–65%, and 66–75%) and  EDP  (>16 or ≤16 mm Hg). We estimated  EDPVR  from single measurements in the catheterization data set. Then, we replaced  EDPVR s of high‐ EDP  groups with those of normal‐ EDP  groups and compared  CO  before and after  EDPVR  replacement. Normalized  EDPVR  significantly increased  CO  at  EDP =10 mm Hg regardless of  EF  ( EF  35–45%, from 4.5±1.6 to 4.9±1.0;  EF  46–55%, 4.6±1.3 to 5.1±1.1;  EF  56–65%, 4.9±1.5 to 5.2±1.0;  EF  66–75%, 4.9±1.5 to 5.2±1.1). Changes in  CO  were similar across  EF  groups.    Conclusions  Diastolic function normalization was associated with higher  CO  irrespective of  EF . Diastolic dysfunction plays an important role in determining  CO  irrespective of  EF  in heart failure patients.

Improved Diastolic Function Is Associated With Higher Cardiac Output in Patients With Heart Failure Irrespective of Left Ventricular Ejection Fraction