Systolic and diastolic heart failure may represent different clinical presentations within a phenotypic spectrum of the same disease rather than separate diseases with distinct pathophysiology.
Proposes a novel paradigm in which systolic and diastolic heart failure are viewed as different phenotypic presentations of the same disease rather than separate entities.
Traditional pathophysiological concepts of chronic heart failure have largely focused on the haemodynamic consequences of ventricular systolic dysfunction. How these concepts relate to the pathophysiology of diastolic heart failure, i.e., heart failure with a preserved ejection fraction is, however, unclear, causing uncertainty about pathophysiology, diagnosis and management. Recent measurements of regional myocardial systolic function in patients with diastolic heart failure indicate that systolic and diastolic heart failure may be more closely related than previously anticipated. Rather than being considered as separate diseases with a distinct pathophysiology, systolic and diastolic heart failure may be merely different clinical presentations within a phenotypic spectrum of one and the same disease. In this review, we will interpret these new insights in a broader conceptual context of chronic heart failure and design novel paradigms in which systolic and diastolic heart failure jointly progress in a pathophysiological time trajectory of only one disease.
Keulenaer et al. (Wed,) conducted a review in Chronic heart failure. Systolic and diastolic heart failure may represent different clinical presentations within a phenotypic spectrum of the same disease rather than separate diseases with distinct pathophysiology.