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Nosology of diastolic heart failure. Volume 3, issue 6, Novembre-Décembre 2007

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Hôpital cardiologique Haut-Lévêque, Avenue Magellan, 33600 Pessac

Despite significant efforts to reach a consensus, diastolic heart failure is still an imperfectly defined entity. Its diagnosis is based on the association of a clinical syndrome of heart failure, a normal or preserved (> 45%) ejection fraction, signs of diastolic dysfunction, and a concentric remodeling of the left ventricle. About 50% of patients presenting with signs or symptoms of heart failure have a normal or preserved ejection fraction. It is impossible to differentiate between diastolic and systolic heart failure on the basis of clinical criteria. However, patients suffering from diastolic heart failure are usually older, more frequently women, more likely to present with systemic hypertension, and less likely to have coronary artery disease than those suffering from systolic heart failure. Its prognosis appears less severe than that of systolic heart failure. However, its morbidity and economic cost are similar.