Diastolic heart failure involves the left side of the heart. It causes a stiff left ventricle that prevents the heart from relaxing between beats. This means that the heart cannot pump an adequate amount of blood throughout the body or has to pump with increased pressure.

Both systolic and diastolic heart failure involve the left side of the heart. Both types of heart failure can eventually lead to right-ventricle heart failure over time.

However, there are important differences between the two. For example, with systolic heart failure, the left ventricle becomes weak. With diastolic heart failure, the left ventricle bulks.

There are many symptoms, causes, and treatments for this high-mortality condition. Read on to learn more about diastolic heart failure.

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Diastolic heart failure happens when the heart does not relax properly between beats. This means it is unable to pump blood throughout the body the way it should and has to function at a higher pressure, which can cause symptoms.

If the heart pumps less blood, less oxygen goes to vital organs and tissues.

Heart contractions and diastolic heart failure

When the heart muscles contract, known as the systolic phase, the heart twists and closes slightly — like a wringing motion.

Then, in the diastole phase, the muscle fibers relax, unwind, and stretch.

Each of these motions is essential for allowing the heart to expand and draw blood into the ventricles.

With diastolic heart failure, the second phase of a heartbeat is challenged by its inability to relax. This means the heart must work overtime to do its job.

Learn more about the systole and diastole phases.

Vs. systolic heart failure

Systolic and diastolic heart failure both occur in the left ventricle of the heart, but can also include the right ventricle.

Systolic heart failure happens when the pumps of the heart are not strong enough to move blood around the body effectively.

Diastolic heart failure means the heart does not relax correctly between beats.

In both cases, the heart is not pumping blood as efficiently as it should.

A person can experience systolic and diastolic heart failure at the same time.

Learn about systolic vs. diastolic heart failure.

Ejection fraction

Diastolic heart failure is also known as heart failure with preserved ejection fraction (HFpEF).

Ejection fraction is how doctors measure what proportion of the blood leaves the heart each time it contracts.

A healthy heart should pump blood at an ejection fraction of 55% or more.

If the ejection fraction is lower than this, it can mean there is damage or heart failure involving the left ventricle, and systolic dysfunction is present.

Several factors may lead to a person being more likely to develop diastolic heart failure.

Who is most likely to have heart failure?

Heart failure is most common among older adults. Statistics show that heart failure affects around 1 in every 100 people aged over 50 years and that this number doubles every decade that a person lives.

Underlying conditions

Diastolic heart failure may arise from any number of pre-existing conditions, such as:

Is it hereditary?

Diastolic heart failure may also be hereditary.

People may be more prone to the condition if people in their family history had conditions that can cause it, such as high blood pressure.

Additionally, certain types of genetic conditions link to diastolic heart failure, such as hypertrophic cardiomyopathy, an inherited heart muscle abnormality. It causes the left ventricle walls to thicken and stiffen, which could lead to diastolic heart failure.

Certain inherited forms of amyloidosis can lead to diastolic heart failure.

The first symptoms a person with diastolic heart failure might notice are the same symptoms that come with any type of heart failure, including:

A person may notice that any kind of physical exertion, including day-to-day activities, becomes much more difficult due to fatigue and shortness of breath.

Learn about the symptoms of congestive heart failure.

According to the American Heart Association (AHA), there are two ways to stage heart failure.

The first is the New York Heart Association (NYHA) Functional Classification. This method examines a person’s physical ability and has the following stages:

StageSymptoms
1Physical activity does not cause problems for the person, such as tiredness, palpitations, or shortness of breath.
2There are some limitations in the person’s physical activity.
The person feels comfortable when resting.
The person’s usual physical activity makes them tired, gives them palpitations, or causes shortness of breath.
3There are substantial limitations in the person’s physical activity.
The person feels comfortable when resting.
Physical activities that are less difficult than daily tasks cause fatigue, palpitations, or shortness of breath.
4The person cannot do any kind of activity without experiencing discomfort.
The person notices symptoms of heart failure at rest.
If the person tries any physical activity, they feel even more uncomfortable.

The ACC/AHA stages of heart failure guidelines provide an objective assessment of cardiovascular disease:

StageObjective assessment
A: At riskThe person has no heart disease, but they have risk factors for heart failure, such as hypertension or family history.
B: Pre-heart failureThere is structural heart disease or increased filling pressures but no symptoms.
C: Symptomatic heart failureThe person has structural heart disease with current or past symptoms.
D: Advanced heart failureThere are marked symptoms that interfere with daily life despite medical treatment.

A doctor may use both of these methods to classify a person’s stage of heart failure.

For example, if a person is experiencing no symptoms, but their ejection fraction is 45%, they have NYHA Class I, ACC/AHA Stage B heart failure.

A doctor may order the following tests to diagnose diastolic heart failure:

  • Blood tests: A doctor may use blood tests to measure molecules that increase during heart failure, such as brain natriuretic peptide. Blood tests may also show a doctor whether a person’s liver or kidneys are working well.
  • Echocardiography: An echocardiogram can help a doctor measure a person’s ejection fraction.
  • Other imaging tests: A doctor may order more imaging tests to check a person’s heart structure and function, such as:
  • Electrical tests: A person may require tests of their electrical functions, such as:
  • Stress tests: This test stresses the heart with exercise or medication to assess its response to stress and its effect on blood flow to the heart, if any.

Learn what could cause an abnormal electrocardiogram.

There is currently no cure for any kind of heart failure.

However, a person can improve their symptoms and outlook with the right treatment.

Behavioral changes

A person can take up heart-healthy habits to help treat and manage diastolic heart failure. These can include:

Learn about how to follow a cardiac diet.

Medications

A person may require medicines that can help treat symptoms of diastolic heart failure, including:

TypeFunctionExample
Aldosterone antagonistsreduce the amount of blood that the heart must pumpspironolactone
Diureticstreat fluid overload and reduce edemafurosemide
Blood pressure medicationslower blood pressureACE-inhibitors, spironolactone
Antiarrhythmic medicationstreat atrial fibrillationbeta-blockers, digoxin
SGLT2 inhibitorslower glucose and reduce cardiovascular riskglifozins

A person can live many years after a diagnosis of diastolic heart failure, but they might need to follow a long-term treatment plan to help them manage the condition.

In 2019, researchers published a study that looked at data for 55,959 people who received a diagnosis of diastolic heart failure in the United Kingdom from 2000 to 2017.

The results suggest that, after receiving a diagnosis of diastolic heart failure, the overall chances of survival are as follows:

TimeSurvival rate
1 year or longer75.9%
5 years or longer45.5%
10 years or longer24.5%
15 years or longer12.7%

People who did not have to spend time in the hospital at the time of their initial diagnosis were more likely to survive longer than those who did.

Here are some questions people often ask about diastolic heart failure.

How long can you live with diastolic heart failure?

Some research suggests that over 75% of people who receive a diagnosis of diastolic heart failure will live at least one more year, and over 12% will live 15 years longer or more.

Is diastolic heart failure serious?

Diastolic heart failure can be serious, but treatment can often manage it effectively, particularly with an early diagnosis. People who are in hospital for diastolic heart failure when they receive their diagnosis are more likely to have severe symptoms, which can affect their outlook.

Which heart failure is worse, diastolic or systolic?

Despite research, experts are unable to say whether one is more dangerous than the other. Other factors can also affect the outcome, such as a person’s age and whether or not they smoke. It is best to assume that both are potentially dangerous for health. It is essential for people to seek medical help and follow the treatment plan to avoid potentially severe complications.

Diastolic heart failure directly affects the function of the heart, impairing its ability to pump blood to essential organs.

Though there is no known cure, early diagnosis and treatment of heart failure symptoms are essential for managing the condition and extending life expectancy.

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