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Edu Current Opinion in Cardiology 2009, 24:230–238 Purpose of review Diastolic heart failure (DHF) is the culmination of various cardiovascular insults, producing a proportionally greater alteration of diastolic performance, subtle reductions of systolic function and the clinical syndrome of heart failure. Over half of heart failure patients aged 65 years or older have DHF, which carries similar morbidity and mortality to systolic heart failure (SHF). The aging population and increased prevalence of hypertension, diabetes mellitus and obesity will result in disproportionately higher incidence of DHF.

35, has been observed in more than 50%. Ghio et al. [10] demonstrated the independent and additive effects of RV dysfunction and pulmonary hypertension in a low LVEF heart failure cohort. They also observed an inverse relation between RVEF and mean pulmonary artery pressures, suggesting that persistent elevation of pulmonary pressures is pathophysiologically important, and that RV dysfunction is not simply an epiphenomenon of the left ventricular cardiomyopathic process [10]. Javaheri et al. [19] assessed the prognostic significance of sleep-disordered breathing in patients with systolic heart failure.

JAMA 2002; 288:2144–2150. 45 Pocock SJ, Wang D, Pfeffer MA, et al. Predictors of mortality and morbidity in patients with chronic heart failure. Eur Heart J 2006; 27:65–75. 29 Farr MJ, Lang CC, Lamanca JJ, et al. Cardiopulmonary exercise variables in diastolic versus systolic heart failure. Am J Cardiol 2008; 102:203–206. 46 Cleland JG, Tendera M, Adamus J, et al. The perindopril in elderly people with chronic heart failure (PEP-CHF) study. Eur Heart J 2006; 27:2338–2345. 30 Flather MD, Shibata MC, Coats AJ, et al.

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