Russian Heart Failure Journal 2009year What we know and what we don’t know about diastolic heart failure in XXI century


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2009/

What we know and what we don’t know about diastolic heart failure in XXI century

Kastanayan A. А., Nelasov N. Y.

Keywords: XXI century, diagnostics, treatment

DOI:

Heart failure (HF) with normal ejection fraction (HF-NEF) is more than 50 % of all cases of HF. Till now it is not well known if HF-NEF and HF with decreased ejection fraction (HF-DEF) are independent syndomes or different manifestations of one condition. Due to appearance of impulse-wave tissue dopplerography (ITD) and detection of plasma level of natriuretic peptides more accurate diagnostic criteria of HF-NEF appeared in clinical practise. If ITD shows Е / Е’ >8, but <15, then additional non-invasive researches for LV diastolic disfunction (DD) approvement are needd. Analysis of high-amplitude reflected movement signals (HARMS) registered fr om left heart parts with usual impulse-wave dopplerography, is high sensitive method of DD diagnostic. Modern guidelines for HF-NEF treatment are based on certain data about pathogenesis, treatment principles of other cardiovascular diseases and experts opinion. In small trials on HF-NEF treatment authors used different criteria that lim it impartial comparison of results. In futrther clinical trials on HF-NEF not just ECHO-CG is essential, but also quantitative detection of natriuretic peptides.
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