Diastolic heart failure: State of the science on best treatment practices

Purpose: The purpose of this article is to increase awareness among nurse practitioners (NPs) of the current state of the science on diastolic heart failure (DHF), the American College of Cardiology (ACC) and the American Heart Association (AHA) guidelines for DHF, and pathophysiology, diagnosis, and nonpharmacological and pharmacological management of DHF. Data sources: The articles included in the review of the state of the science were retrieved by a search of PUBMED literature using the following key search terms: heart failure, diastolic heart failure, preserved systolic function, heart failure management, treatment of diastolic heart failure, treatment of diastolic dysfunction, and treatment of preserved systolic function. Current published guidelines from the ACC and AHA were reviewed to establish clinical recommendations for patients with DHF. Conclusions: The state of the science and clinical recommendations for DHF are in the early stages compared to those for systolic heart failure (SHF). The need for more randomized clinical trials on nonpharmacological and pharmacological management and the development of standardized guidelines for DHF patients are clearly apparent. Implications for practice: Both nonpharmacologic and pharmacologic management are effective and necessary to control the clinical signs and symptoms of DHF and improve overall quality of life. Successful tailoring of a treatment plan to suit each individual patient's needs and including the family are important for the NP to consider.