How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology

作者：Walter J. Paulus, Carsten Tschöpe, John Elsby Sanderson, C Rusconi, Frank Arnold Flachskampf, Frank E Rademakers, Paolo Nicola Marino, Otto Armin Smiseth, Gilles W. De Keulenaer, Adelino Ferreira Leite-Moreira, Attila Borbély, Istvan Ferenc Edes, M. Louis Handoko, Stephane R B Heymans, Natalia Pezzali, Burkert Mathias Pieske, Kenneth Dickstein, Alan G. Fraser, Dirk L. Brutsaert · 发表于：European Heart Journal · 年份：2007 · DOI：10.1093/eurheartj/ehm037 · 被引用次数：2689 · 研究领域：Cardiovascular Function and Risk Factors、Cardiac Valve Diseases and Treatments、Heart Failure Treatment and Management

Diastolic heart failure (DHF) currently accounts for more than 50% of all heart failure patients. DHF is also referred to as heart failure with normal left ventricular (LV) ejection fraction (HFNEF) to indicate that HFNEF could be a precursor of heart failure with reduced LVEF. Because of improved cardiac imaging and because of widespread clinical use of plasma levels of natriuretic peptides, diagnostic criteria for HFNEF needed to be updated. The diagnosis of HFNEF requires the following conditions to be satisfied: (i) signs or symptoms of heart failure; (ii) normal or mildly abnormal systolic LV function; (iii) evidence of diastolic LV dysfunction. Normal or mildly abnormal systolic LV function implies both an LVEF > 50% and an LV end-diastolic volume index (LVEDVI) <97 mL/m(2). Diagnostic evidence of diastolic LV dysfunction can be obtained invasively (LV end-diastolic pressure >16 mmHg or mean pulmonary capillary wedge pressure >12 mmHg) or non-invasively by tissue Doppler (TD) (E/E' > 15). If TD yields an E/E' ratio suggestive of diastolic LV dysfunction (15 > E/E' > 8), additional non-invasive investigations are required for diagnostic evidence of diastolic LV dysfunction. These can consist of blood flow Doppler of mitral valve or pulmonary veins, echo measures of LV mass index or left atrial volume index, electrocardiographic evidence of atrial fibrillation, or plasma levels of natriuretic peptides. If plasma levels of natriuretic peptides are elevated, diagnostic evid...