Heart failure due to abnormal filling function of the heart

Symptoms of heart failure can be caused by the diastolic dysfunction even in patients with normal ejection fraction, and this condition has been called diastolic heart failure. After Kitabatake and his associates first used echo-Doppler to characterize the transmitral flow velocity in various disease states in 1982, there have been remarkable advances in the evaluation of diastolic function with Doppler echocardiography. Types of diastolic dysfunction can be classified into relaxation abnormality, pseudonormal, reversible restrictive physiology, and irreversible restrictive physiology. Classifying the patients into these types, in addition to the reliable estimation of left ventricular filling pressure with Doppler echocardiography, enables us to adjust treatment in individual patients and to get information about the prognosis. The main hemodynamic abnormality in patients with diastolic dysfunction is the abnormal filling function of the heart. Therefore, if we expand the scope of diastolic heart failure, patients with constrictive pericarditis can also be categorized into diastolic heart failure. The purpose of this review is to refine our knowledge in the concept of diastolic dysfunction and to update the methods used in its' evaluation. (C) 2011 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.