Diastolic Heart
Failure More Common Than Systolic Form - Symptoms are the Same But
Treatments Could Vary For Ejection - Relaxation Fraction
July 20th 2006
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Echocardiogram |
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Mayo Clinic researchers say that diastolic heart failure is increasing
and now accounts for more than half of heart failure cases. They
evaluated data from a 15 year period and discovered that this heart
failure, which is characterized by a preserved ejection fraction,
affects more than half of the total 5 million heart failure patients.
The percentage of these cases increase from 38 percent to 47 percent to
54 percent in three consecutive five-year periods. There were 4,596
heart failure patients in this study. Hypertension, atrial fibrillation
and diabetes can worsen this type of heart failure.
The other type of heart failure is systolic failure. The ratio has
changed because there are more diastolic heart failure patients, with no
change in the number of systolic heart failure cases. The mortality
rates for the two types of heart failure are about the same.
The authors say there were therapy improvements made in treating
systolic heart failure but none “was observed” for diastolic. Doctor
Margaret Redfield said “These data confirm that heart failure with
preserved ejection fraction, also known as diastolic heart failure, is a
growing concern. Nearly all previous studies of therapies for heart
failure have excluded patients with diastolic heart failure. This type
of heart failure is poorly understood. It is possible that therapies for
this type of heart failure will need to be very different from those
which are of benefit in systolic heart failure.” Redfield is the lead
author and director of the Mayo Clinic’s Hear Failure Clinic.
Diastolic heart failure usually affects elderly women. Redfield says
“There are a number of likely reasons why patients with systolic heart
failure are doing better. Research has helped us discover many
therapies for systolic heart failure — drugs, devices and surgical
procedures — to counteract the mechanisms that cause or worsen systolic
heart failure, and we’ve seen the proven benefit of those therapies in
large scale clinical trials. This approach now needs to be expanded to
the other half of the heart failure epidemic, patients with diastolic
heart failure.”
Patients with heart failure have a heart with a “reduced pumping
function” as measured by the ejection fraction (systolic heart failure)
or reduced relaxing function with preserved ejection fraction (diastolic
heart failure). Although the symptoms for the two types of failure are
the same, their treatments may vary. Patients usually need an
echocardiogram to distinguish between the two forms of heart failure.
The research is published in the July 19 issue of the New England
Journal of Medicine.
Marsha Quinn
Writer
Books on Heart Disease
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