Heart failure

Diastolic heart failure: symptoms, causes and treatment

Heart failure is a broad term that describes several conditions when the heart has weakened and no longer effectively pumps blood to the rest of the body.

In the case of diastolic heart failure, the left ventricle has become stiff and cannot fill with blood during the pauses between heartbeats and does not relax normally. This condition is sometimes referred to as heart failure with preserved ejection fraction.

Recognizing the early symptoms of diastolic heart failure is essential to begin treatment before the heart weakens further. Although heart failure is a serious disease with no current cure, improvements in drugs and medical technology have improved the outlook for many people facing the disease.

Heart failure

Heart failure does not mean that the heart has stopped beating. It just means that due to a heart attack or other damage, it is weaker and less effective than before. The heart is still beating, but it cannot pump the volume of blood to adequately supply all of your organs and other tissues, or it is operating at higher pressures to do so.

With lifestyle measures, medications, and procedures to improve blood flow and fix heart valve problems, many people can live with heart failure for a long time.

Diastole vs systole

To better understand diastolic heart failure, it helps to know the difference between diastole and systole.

With each beat of your heart (systole), the left ventricle (lower left chamber) pumps blood to the body, while the right ventricle (lower right chamber) pumps blood to the lungs for oxygen.

At the same time, your right and left atria (upper chambers) fill with blood. Between beats (diastole), the atria move blood through the ventricles to be ready for the next heartbeat.

Diastolic heart failure

Diastolic heart failure occurs when the left ventricle cannot relax enough to fill with enough blood, or does so at higher pressures. So when the heart beats, less than normal amount of blood is pumped to the body. Over time, organs can suffer from reduced flow of oxygen- and nutrient-rich blood and higher filling pressures.

Diastolic heart failure is also called heart failure with preserved ejection fraction (HFpEF). The ejection fraction measures the amount of blood pumped out of the left ventricle each time the heart muscle contracts.

A healthy heart typically has an ejection fraction of between 50 and 70 percent. HFpEF can be diagnosed with an ejection fraction of 40 to 49 percent. The ejection fraction might be higher in some cases of diastolic heart failure, but in these cases the left ventricle does not fill as much with blood as it normally should.

In the early stages of diastolic heart failure, you may not notice any symptoms. But as the disease progresses, some of the following symptoms are likely to develop:

These symptoms can range from mild to moderate at first, but without treatment they are likely to get worse over time.

Diastolic heart failure means the heart muscle has become stiff. As with many cardiovascular diseases, aging is one of the main causes of diastolic heart failure. Other common causes and risk factors for diastolic heart failure include:

  • coronary artery disease
  • Diabetes
  • obesity
  • aortic stenosis
  • obstructive sleep apnea
  • kidney disease

A 2016 study notes that diastolic heart failure is now the most common form of heart failure. It also suggests that the key to successful treatment is “aggressive management of contributing factors”. This means that the treatment for diastolic heart failure also involves the proper treatment of any other conditions you may have, as listed above.

Specifically, treatment for diastolic heart failure usually involves a combination of the following therapies:

Medications

The right combination of drugs depends on the nature of your heart failure and whether other conditions are present.

A 2021 study found that a sodium-glucose co-transporter 2 inhibitor called empagliflozin reduced the risk of cardiovascular death and hospitalization for people with diastolic heart failure.

A 2020 journal article reported that the diuretic spironolactone, when added to other hypotensive drugs, improved outcomes for people with diastolic heart failure and resistant hypertension.

Exercise

Because heart failure can make it difficult and possibly dangerous to exercise too much, the American Heart Association recommends finding a cardiac rehabilitation program that will teach you the right way to exercise by. safely and to avoid complications afterwards.

Procedures

If a blocked blood vessel is contributing to your diastolic heart failure, you may benefit from angioplasty. This is a procedure in which a small balloon is inflated in the blocked part of the artery, opening it wider for better blood flow. In some cases, a flexible mesh tube called a stent is left in place to help keep the artery open.

If a heart valve problem has caused left ventricle problems, you may be a candidate for heart valve replacement or repair.

Diastolic heart failure is a chronic condition that can be managed with proper treatment and a heart-friendly lifestyle.

A Study 2020 Notes that the annual death rate for the 6 million people in the United States with diastolic heart failure is between 8 and 12 percent, with older people at the top of that estimate. Some estimates suggest that about half of people with heart failure will live at least 5 years after diagnosis, while about 30% will live at least 10 years.

It is important to have your symptoms checked soon after they appear. Working closely with a healthcare professional after a heart failure diagnosis will give you the best chance of living longer and having a better quality of life.


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