Diastolic heart failure, or with preserved systolic function, represents between 30% and 50% of all cases of heart failure, and its prognosis is almost as unfavorable as that of patients with heart failure (HF) with impaired function. depressed systolic
At present, only the presence of strict clinical criteria of HF and a preserved left ventricular ejection fraction (LVEF) (greater than 40-50%) are required for diagnosis, although the determination of brain natriuretic peptide values may have interest for the diagnosis in the future.
Since there is no evidence derived from important clinical trials, except for the slight benefit obtained with candesartan in the CHARM study in the reduction of readmissions, its treatment is based on the identification and treatment of its etiology (hypertension, ischemic heart disease), control of heart rate and relief of congestion, so the combination of low-dose diuretics, bradycardia antihypertensives (beta-blockers, calcium channel blockers) and angiotensin antagonists now seems to be the best therapeutic strategy.
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