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In clinical cardiology the term "diastolic function" is most commonly referred as how the heart fills. [1] Parallel to "diastolic function", the term " systolic function" is usually referenced in terms of the left ventricular ejection fraction (LVEF), which is the ratio of stroke volume and end-diastolic volume . [ 2 ]
Heart failure with preserved ejection fraction (HFpEF) is a form of heart failure in which the ejection fraction – the percentage of the volume of blood ejected from the left ventricle with each heartbeat divided by the volume of blood when the left ventricle is maximally filled – is normal, defined as greater than 50%; [1] this may be measured by echocardiography or cardiac catheterization.
Heart Failure Preserved Ejection Fraction (HFPEF) is now the preferred term for Diastolic Heart Failure. This term was used in the 2016 European Society of Cardiology Heart Failure Guidelines. "Diastolic Heart Failure" was the term used in papers published in the early 2000's <ref> Eur Heart J 2016;37:2129–2200.
The reversal of the E/A ratio ('A' velocity becomes greater than 'E' velocity) is often accepted as a clinical marker of diastolic dysfunction, in which the left ventricular wall becomes so stiff as to impair proper filling, which can lead to diastolic heart failure. This can occur, for instance, with longstanding untreated hypertension.
Diastolic dysfunction is associated with a reduced compliance, or increased stiffness, of the ventricle wall. This reduced compliance results in an inadequate filling of the ventricle and a decrease in the end-diastolic volume. The decreased end-diastolic volume then leads to a reduction in stroke volume because of the Frank-Starling mechanism. [1]
Left ventricular hypertrophy. Hypertensive heart disease is the result of structural and functional adaptations [18] leading to left ventricular hypertrophy, [19] [20] [21] diastolic dysfunction, [18] [20] CHF (Congestive Heart Failure), abnormalities of blood flow due to atherosclerotic coronary artery disease [18] and microvascular disease, [10] [19] and cardiac arrhythmias. [19]
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