Heart failure with preserved systolic function - A different natural history?

Three well-controlled epidemiology studies in the U.S. have reported that 4 0% of incident congestive heart failure (CHF) cases and 50% to 60% of preva lent CHF cases occur in the setting of preserved systolic function. This co ndition has been termed "diastolic heart failure" (DHF). Despite minor diff erences in the types of populations examined, these community-based studies have established DHF as a major health problem in the U.S., particularly a mong the elderly. Although extensive data are available concerning the natu ral history, of CHF associated with reduced systolic dysfunction (systolic heart failure; SHF), the natural history of DHF is not well-characterized. Indeed, it remains unclear whether patients with DHF share the grim prognos is described for patients with SHF. In this review we examine the available studies comparing survival observed in patients with DHF to that observed in patients with SHF. Although there are insufficient data at present to ma ke definitive conclusions, careful examination of the available studies rai ses the possibility, that the natural history of patients with DHF may not be different from that observed in patients with CHF and reduced systolic f unction. (J Am Coll Cardiol 2001;38:1277-82) (C) 2001 by, the American Coll ege of Cardiology.