Diastolic heart failure: boundaries of term application

Important changes regarding the understanding of the pathogenesis of chronic heart failure (CHF) marked the beginning of the millennium, and its first decade was called the decade of diastology. Even though numerous studies convincingly proved that deterioration of the left ventricular (LV) filling...

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Main Authors: V. V. Kalyuzhin, A. T. Teplyakov, I. D. Bespalova, E. V. Kalyuzhina, G. E. Chernogoryuk, N. N. Terentyeva, E. V. Grakova, K. V. Kopeva, V. Yu. Usov, N. P. Garganeeva, O. A. Pavlenko, Yu. V. Gorelova
Format: Article
Language:English
Published: Siberian State Medical University (Tomsk) 2023-04-01
Series:Бюллетень сибирской медицины
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Online Access:https://bulletin.ssmu.ru/jour/article/view/5141
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author V. V. Kalyuzhin
A. T. Teplyakov
I. D. Bespalova
E. V. Kalyuzhina
G. E. Chernogoryuk
N. N. Terentyeva
E. V. Grakova
K. V. Kopeva
V. Yu. Usov
N. P. Garganeeva
O. A. Pavlenko
Yu. V. Gorelova
author_facet V. V. Kalyuzhin
A. T. Teplyakov
I. D. Bespalova
E. V. Kalyuzhina
G. E. Chernogoryuk
N. N. Terentyeva
E. V. Grakova
K. V. Kopeva
V. Yu. Usov
N. P. Garganeeva
O. A. Pavlenko
Yu. V. Gorelova
author_sort V. V. Kalyuzhin
collection DOAJ
description Important changes regarding the understanding of the pathogenesis of chronic heart failure (CHF) marked the beginning of the millennium, and its first decade was called the decade of diastology. Even though numerous studies convincingly proved that deterioration of the left ventricular (LV) filling pressure often precedes impairment of its systolic function and a number of factors affect (especially at the onset) mainly the diastolic function without changing the conditions of blood ejection, modern classifications and approaches to CHF treatment are primarily based on the results of LV ejection fraction (EF) assessment.In recent years, diastolic heart failure (DHF) has been often overlooked and replaced by the ambiguous term “CHF with preserved EF”. However, sometimes authors use the term DHF extensively, since CHF based on myocardial insufficiency develops only via two mechanisms (systolic and / or diastolic dysfunction), and excluding one of the mechanisms allows to identify the underlying one. The term DHF can be used in clinical practice and cannot be replaced by the diagnosis of CHF with preserved EF. CHF with preserved EF is a broader concept which includes a full spectrum of cardiovascular diseases, complicated by the development of CHF without depression of the global LV contractility and requiring differentiated approaches to therapy. In addition, the results of repeated studies on LVEF in many patients may require reclassification of this CHF phenotype, which is established following the analysis of the baseline value of global LV contractility. We join M.R. Zile in the appeal to stop discriminating against the term “DHF” and present the boundaries of its correct application.
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record_format Article
series Бюллетень сибирской медицины
spelling doaj-art-310af8287ee444ff8a39bba9e61632f12025-08-20T03:37:46ZengSiberian State Medical University (Tomsk)Бюллетень сибирской медицины1682-03631819-36842023-04-0122111312010.20538/1682-0363-2023-1-113-1202972Diastolic heart failure: boundaries of term applicationV. V. Kalyuzhin0A. T. Teplyakov1I. D. Bespalova2E. V. Kalyuzhina3G. E. Chernogoryuk4N. N. Terentyeva5E. V. Grakova6K. V. Kopeva7V. Yu. Usov8N. P. Garganeeva9O. A. Pavlenko10Yu. V. Gorelova11Siberian State Medical UniversityCardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of ScienceSiberian State Medical UniversitySiberian State Medical UniversitySiberian State Medical UniversitySurgut State UniversityCardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of ScienceCardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of SciencesCardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of SciencesSiberian State Medical UniversitySiberian State Medical UniversitySiberian State Medical UniversityImportant changes regarding the understanding of the pathogenesis of chronic heart failure (CHF) marked the beginning of the millennium, and its first decade was called the decade of diastology. Even though numerous studies convincingly proved that deterioration of the left ventricular (LV) filling pressure often precedes impairment of its systolic function and a number of factors affect (especially at the onset) mainly the diastolic function without changing the conditions of blood ejection, modern classifications and approaches to CHF treatment are primarily based on the results of LV ejection fraction (EF) assessment.In recent years, diastolic heart failure (DHF) has been often overlooked and replaced by the ambiguous term “CHF with preserved EF”. However, sometimes authors use the term DHF extensively, since CHF based on myocardial insufficiency develops only via two mechanisms (systolic and / or diastolic dysfunction), and excluding one of the mechanisms allows to identify the underlying one. The term DHF can be used in clinical practice and cannot be replaced by the diagnosis of CHF with preserved EF. CHF with preserved EF is a broader concept which includes a full spectrum of cardiovascular diseases, complicated by the development of CHF without depression of the global LV contractility and requiring differentiated approaches to therapy. In addition, the results of repeated studies on LVEF in many patients may require reclassification of this CHF phenotype, which is established following the analysis of the baseline value of global LV contractility. We join M.R. Zile in the appeal to stop discriminating against the term “DHF” and present the boundaries of its correct application.https://bulletin.ssmu.ru/jour/article/view/5141left ventriclesystolediastoleheart failure with preserved ejection fractiondiastolic heart failurediastologyvisualization of the heart
spellingShingle V. V. Kalyuzhin
A. T. Teplyakov
I. D. Bespalova
E. V. Kalyuzhina
G. E. Chernogoryuk
N. N. Terentyeva
E. V. Grakova
K. V. Kopeva
V. Yu. Usov
N. P. Garganeeva
O. A. Pavlenko
Yu. V. Gorelova
Diastolic heart failure: boundaries of term application
Бюллетень сибирской медицины
left ventricle
systole
diastole
heart failure with preserved ejection fraction
diastolic heart failure
diastology
visualization of the heart
title Diastolic heart failure: boundaries of term application
title_full Diastolic heart failure: boundaries of term application
title_fullStr Diastolic heart failure: boundaries of term application
title_full_unstemmed Diastolic heart failure: boundaries of term application
title_short Diastolic heart failure: boundaries of term application
title_sort diastolic heart failure boundaries of term application
topic left ventricle
systole
diastole
heart failure with preserved ejection fraction
diastolic heart failure
diastology
visualization of the heart
url https://bulletin.ssmu.ru/jour/article/view/5141
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AT atteplyakov diastolicheartfailureboundariesoftermapplication
AT idbespalova diastolicheartfailureboundariesoftermapplication
AT evkalyuzhina diastolicheartfailureboundariesoftermapplication
AT gechernogoryuk diastolicheartfailureboundariesoftermapplication
AT nnterentyeva diastolicheartfailureboundariesoftermapplication
AT evgrakova diastolicheartfailureboundariesoftermapplication
AT kvkopeva diastolicheartfailureboundariesoftermapplication
AT vyuusov diastolicheartfailureboundariesoftermapplication
AT npgarganeeva diastolicheartfailureboundariesoftermapplication
AT oapavlenko diastolicheartfailureboundariesoftermapplication
AT yuvgorelova diastolicheartfailureboundariesoftermapplication