Reversible left ventricular diastolic dysfunction—Overview and clinical implications

Strong evidence supports a pathophysiological link between left ventricular diastolic dysfunction (LVDD) and symptoms in many patients with heart failure, including those with normal LV ejection fraction. Thus, echocardiographic assessment of LV diastolic function is currently recommended when evaluating patients with dyspnea of suspected or known cardiac origin. Beyond the well-established role in the diagnostic algorithm of heart failure, LVDD is an independent predictor of cardiovascular events in various patient cohorts and in the general population. Moreover, several studies suggested a dynamic link between ventricular relaxation, filling dynamics, and prognosis. Thus, worsening of LVDD emerged as a marker of worse prognosis, whereas its improvement is associated with better outcomes. From this perspective, it is important for clinicians to recognize the potentially reversible causes of LVDD that can be identified and treated with symptomatic and/or prognostic benefits. The purpose of this review is to discuss several clinical conditions associated with reversible LVDD, from possible mechanisms to potential clinical implications.