Peer-review started: July 17, 2019
First decision: August 2, 2019
Revised: October 17, 2015
Accepted: November 26, 2019
Article in press: November 26, 2019
Published online: January 26, 2020
Nearly six million people in United States have heart failure. Fifty percent of these people have normal left ventricular (LV) systolic heart function but abnormal diastolic function due to increased LV myocardial stiffness. Most commonly, these patients are elderly women with hypertension, ischemic heart disease, atrial fibrillation, obesity, diabetes mellitus, renal disease, or obstructive lung disease. The annual mortality rate of these patients is 8%-12% per year. The diagnosis is based on the history, physical examination, laboratory data, echocardiography, and, when necessary, by cardiac catheterization. Patients with obesity, hypertension, atrial fibrillation, and volume overload require weight reduction, an exercise program, aggressive control of blood pressure and heart rate, and diuretics. Miniature devices inserted into patients for pulmonary artery pressure monitoring provide early warning of increased pulmonary pressure and congestion. If significant coronary heart disease is present, coronary revascularization should be considered.
Core tip: Three million people in United States have heart failure with normal left ventricular systolic function but abnormal diastolic function due to increased myocardial stiffness. These patients are often elderly women with hypertension, ischemic heart disease, atrial fibrillation, obesity, diabetes mellitus, renal disease, or obstructive lung disease. The annual mortality rate of these patients is 8%-12% per year. The diagnosis is based on history, physical examination, laboratory data, echocardiography, and, when necessary, by cardiac catheterization. These patients often require weight reduction, an exercise program, aggressive control of blood pressure and heart rate, and diuretics. If significant coronary heart disease is present, coronary revascularization should be considered.