Aproximadamente un 40-50% de los pacientes con insuficiencia cardiaca presenta una fracción de eyección normal. Hoy día se asume que la disfunción diastólica es la causa del cuadro, pero persiste cierto grado de controversia derivado de la dificultad que entraña su valoración ecocardiográfica y de una elevada tasa de errores diagnósticos. Se han descrito diferencias epidemiológicas respecto a los pacientes con insuficiencia cardiaca sistólica, aunque la presentación clínica y el pronóstico son similares, con una elevada mortalidad a medio plazo condicionada por una alta prevalencia de comorbilidad y la ausencia de ensayos clínicos aleatorizados que hayan probado terapias eficaces para modificar el curso de la enfermedad. Incluso en pacientes con disfunción diastólica asintomática – condición frecuente en la población general – se ha observado un incremento significativo de la mortalidad por todas las causas.
Palabras clave
Insuficiencia cardiaca
Diástole
Diagnóstico
Pronóstico
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