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TP 7 Diastolic Heart Failure

Background and objective

The heart functions like a mechanical pump, such as a bellows, for example. Blood is pumped from the left ventricle of the heart into the aorta when the myocardium contracts. This phase is known as systole. Afterwards the myocardium relaxes; during this phase the main chambers fill with blood again. This phase is called diastole. Until a few years ago, it was assumed that dysfunctions (failure) occurred primarily in the systolic phase, we know in the meantime that at least as many people, particularly women in the higher age ranges, suffer from diastolic dysfunction, i.e. a problem with filling the heart.

Main result

More than 1900 subjects at risk of or with established diastolic heart failure were recruited, meticulously characterized (including innovative echocardiographic technique, sleep disorder screening, ergospirometry, blood sampling) and are regularly followed long-term (DIAST-CHF study). A spin-off pilot trial investigating the effects of physical training on diastolic performance measures yielded promising results (Ex-DHF trial). Another spin-off trial focussing on the effects of aldosterone receptor antagonism (spironolactone) on echocardiographic and ergospirometric surrogates of diastolic heart failure showed that the condition is modifiable thus opening the avenue for innovative treatment options (ALDO-DHF trial).

Publications

  • Wachter R et al. Blunted frequency-dependent upregulation of cardiac output is related to impaired relaxation in diastolic heart failure. Eur Heart J. 2009;30:3027-36.
  • Stahrenberg R et al. Association of glucose metabolism with diastolic function along the diabetic continuum. Diabetologia. 2010;53:1331-40.
  • Edelmann F et al. Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study. J Am Coll Cardiol. 2011;58:1780-91.

Perspective

All subjects will be followed long-term yielding important information on the natural course of this condition with respect to hard clinical endpoints.

Kontakt

PD Dr. Rolf Wachter
Universitätsmedizin Göttingen
Abteilung Kardiologie und Pneumologie
Tel.: +49 (0)551 399258
E-mail: ed.negnitteog-inu.demnull@rethcaW

Prof. Dr. Burkert Pieske
Medizinische Universität Graz
Klinische Abteilung für Kardiologie
Tel.: +43 (0)316 38512544
E-Mail: ta.zarginudemnull@ekseiP.trekruB