Resources 1 through 3 are excellent brief introductory videos on diastolic dysfunction. Diastolic dysfunction is diagnosed using advanced ultrasonography and the videos will explain the techniques and meaning. These three videos are where to start in learning about diastolic dysfunction.
Resource 4 contains links to the American Society of Echocardiography update on the evaluation of diastolic dysfunction.
Resource 5 and 5a discuss the evaluation and management of acute diastolic dysfunction in peri-operative and critical care medicine. This is an excellent post full of both basic information on diastolic dysfunction for primary care clinicians. The article also has useful suggestions on how to use the evaluation of diastolic dysfunction in the care of perioperative, emergency, and critical care patients.
Resource 6 discusses “How to manage a patient with diastolic heart failure in primary care.
Resource 7 links to the ESC 2016 Heart Failure Guidelines.
Resource 8 discusses (summarizes) the chronic treatment of diastolic dysfunction referencing the 2017 ACC/AHA diastolic dysfunction update.
Resource 9 links to the 2017 ACC/AHA focused update on diastolic dysfunction.
(4) Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging [PubMed Abstract] [Full Text HTML] [Full Text PDF]. J Am Soc Echocardiogr. 2016 Apr;29(4):277-314. doi: 10.1016/j.echo.2016.01.011.
(5) Practical approach to diastolic dysfunction in light of the new guidelines and clinical applications in the operating room and in the intensive care [PubMed Abstract] [Full Text] [Full Text PDF]. Ann Intensive Care. 2018 Oct 29;8(1):100. doi: 10.1186/s13613-018-0447-x.
(5a) Correction to: Practical approach to diastolic dysfunction in light of the new guidelines and clinical applications in the operating room and in the intensive care [Full Text PDF]
(6) How To Manage A Patient With Diastolic Heart Failure In Primary Care [Link to Download the PDF]. 2017
(7) 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC [PubMed Abstract] [Full Text HTML] [Full Text PDF]. Eur J Heart Fail. 2016 Aug;18(8):891-975. doi: 10.1002/ejhf.592. Epub 2016 May 20
(8) [Ten Points To Remember From the] 2017 ACC/AHA/HFSA Focused Update Guideline for the Management of Heart Failure
Apr 30, 2017. Here is the summary regarding Heart Failure with preserved EF:
Stage C HF With Preserved EF (HFpEF): The 2017 Focused Update gives the following:
Class IIa recommendation (Level of Evidence: B-R) for use of aldosterone antagonists in appropriately selected patients with HFpEF (with EF ≥45%, elevated BNP or HF admission within 1 year, estimated glomerular filtration rate >30 and creatinine <2.5 mg/dl, potassium <5.0 mEq /L), to decrease hospitalizations.
Class III recommendation (Level of Evidence: B-R) for routine use of nitrates or phosphodiesterase-5 inhibitors to increase activity or quality of life (QoL) in patients with HFpEF, as there is no benefit.
Class III recommendation (Level of Evidence: B-C) for routine use of nutritional supplements in patients with HFpEF, as there is no benefit.
(9) 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure [PubMed Abstract] [Full Text HTML] [Full Text PDF]
A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America
There is little in the above guidelines about the treatment of heart failure with preserved ejection fraction. I have included that section below: