Diastolic heart failure is defined as a condition caused by increased resistance to the filling of one or both ventricles; this leads to symptoms of congestion from the inappropriate upward shift of the diastolic pressure-volume relation.

Definitive diastolic heart failure	Probable diastolic heart failure*	Possible diastolic heart failure
Definitive evidence of congestive heart failure†	Same as definitive	Same as definitive
and	and	and
Objective evidence of normal left ventricular systolic function in proximity of event‡	Same as definitive	Left ventricular ejection fraction of 50 percent or more not measured within 72 hours of event
and	and	and
Objective evidence of left ventricular diastolic dysfunction§	No conclusive information on left ventricular diastolic function	Same as probable

*- Patients who have definitive evidence of congestive heart failure and objective evidence of normal left ventricular systolic function in proximity of event are accepted as having probable diastolic heart failure provided that mitral valve disease, cor pulmonale, primary volume overload, and noncardiac causes are excluded.

†- Clinical symptoms and signs, supporting chest radiography, typical clinical response to diuretics with or without elevated left ventricular filling pressure, or low cardiac index.

‡- Left ventricular ejection fraction of 50 percent or more within 72 hours of event.

§- Abnormal left ventricular relaxation or filling or distensibility indices on catheterization.

 

References:

1. van Kraaij DJ, van Pol PE, Ruiters AW, de Swart JB, Lips DJ, Lencer N, Doevendans PA. Diagnosing diastolic heart failure. Eur J Heart Fail. 2002 Aug;4(4):419-30. [Medline]

2. Satpathy C, Mishra TK, Satpathy R, Satpathy HK, Barone E. Diagnosis and management of diastolic dysfunction and heart failure. Am Fam Physician. 2006 Mar 1;73(5):841-6. [Medline]

3. Zile MR, Brutsaert DL. New concepts in diastolic dysfunction and diastolic heart failure: Part I: diagnosis, prognosis, and measurements of diastolic function. Circulation. 2002 Mar 19;105(11):1387-93. [Medline]