Heart 2009;95:178-179
EDITORIALS
Diabetes and prognosis: are systolic and diastolic heart failure different?
Dr M Kamalesh, Indiana University, 1481 West 10th Street, Indianapolis 46202, USA; mkamales@iupui.edu
| The first 150 words of the full text of this article appear below. |
SYSTOLIC VERSUS DIASTOLIC FAILURE
Multiple studies across countries have now shown that the long-term prognosis of diastolic heart failure is not very different from that of systolic heart failure.1–3 If that is the case then why bother differentiating between the two types of heart failure? The answer is because the treatment options differ greatly between the two conditions. Whereas treatment (drug and device) is well characterised for systolic dysfunction,4 there are precious few data and options available for treating diastolic dysfunction.4 While ejection fractions and left ventricular cavity size differ between the two forms of heart failure, signs and symptoms and neurohumoral abnormalities are similar between the two. These have been elegantly summarised recently by Chatterjee and Massie5 (table 1). It has even been proposed that these two forms of heart failure may be different phenotypes of the same pathophysiological basis.6 The stimuli responsible for these phenotypic differences are largely unknown.5–7
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