Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Chronic heart failure with preserved ejection fraction – the main diagnostic aspects relevant in patients with coronary heart disease referred for myocardial revascularization

Authors: Ulukhanova U.M., Asymbekova E.U., Kamardinov D.Kh., Buziashvili Yu.I.

DOI: https://doi.org/10.24022/1814-6910-2025-22-3-212-221

UDC: 616.12-008.46-002-07

Link: Clinical Physiology of Blood Circulaiton. 2025; 22 (3): 212-221

Received / Accepted:  06.08.2025 / 17.09.2025

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Abstract

The prevalence of chronic heart failure with preserved ejection fraction (HFpEF) ranges from 20% to 60% of patients with heart failure (HF). In most cases, the main cause of HFpEF is impaired relaxation and reduced ventricular myocardial compliance. The term diastolic heart failure (DHF) can be used as a synonym for HFpEF, which can occur independently or coexist with systolic heart failure. The frequency of adverse outcomes in HFpEF is proportional to the mortality rate in systolic HF or HF with low ejection fraction (LVHF). In recent decades, cardiologists and cardiac surgeons have paid increasing attention to the diagnosis, treatment tactics, and risk of developing major cardiovascular complications in the presence of LVHF. The growth in clinical research on the diagnosis of LVEF-HF best illustrates the significance of left ventricular diastolic dysfunction and its impact on prognosis and treatment tactics. In cardiac surgery, the importance of timely diagnosis, treatment, and prevention of LVHF increases several times, as it is directly related to the immediate and long-term results of surgical intervention. Until recently, the presence of clinical data on HF in combination with structural heart abnormalities and elevated levels of brain natriuretic peptides was considered fundamental in the diagnosis of HFpEF. Changes in the functional and morphological parameters of the heart do not always provide a complete picture of the patient's condition, which is why the method of diastolic stress echocardiography or diastolic stress test (DST) was developed. The aim of this study was to provide an overview of current publications on diastolic heart failure and its diagnosis.

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