George A. Heckman, MD, MSc, FRCPC, Assistant Professor of Medicine, Department of Medicine, McMaster University, Hamilton, ON.
Robert S. McKelvie, MD, PhD, FRCPC, Professor of Medicine, Department of Medicine, McMaster University Hamilton, ON.

Heart failure (HF) is usually associated with reduced left ventricular ejection fraction, but approximately 50% of all patients with HF have a preserved ejection fraction. The mortality and morbidity associated with this condition, which may be the most common form of HF in older persons, is substantial and is on the rise. Currently, there are few evidence-based therapies demonstrated to be beneficial for this condition. The usual therapeutic recommendations consist of the aggressive management of the comorbidities and fluid balance associated with this form of HF. Disease management programs may improve outcomes among older persons with HF and preserved ejection fraction.
Key words: heart failure, diastolic dysfunction, preserved ejection fraction, treatment, clinical outcome.

Diego H. Delgado, MD, Division of Cardiology and Transplant, Toronto General Hospital, Toronto, ON.

The incidence of heart failure is rising rapidly, and it is currently the most common cardiovascular disease. Approximately 20–40% of patients with heart failure have preserved left ventricular systolic function, and an impairment of ventricular relaxation is considered the primary cause. There is controversy surrounding the definition of diastolic dysfunction and the diagnostic criteria for diastolic heart failure. Moreover, there are few studies on therapy for diastolic heart failure, which makes the management of these patients a real challenge.

Key words: heart failure, treatment, diagnosis, diastolic dysfunction.