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Diastolic Heart Failure More Common Than Systolic Form - Symptoms are the Same But Treatments Could Vary For Ejection - Relaxation Fraction

July 20th 2006

Diastolic Heart Failure More Common Than Systolic Form - Symptoms are the Same But Treatments Could Vary For Ejection - Relaxation Fraction


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.

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Marsha Quinn

Books on Heart Disease

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