Overview
Diastolic heart failure (HF), also known as heart failure with preserved ejection fraction (HFpEF), is characterized by impaired ventricular relaxation and filling, leading to elevated diastolic pressures and symptoms of HF 1. Stage C HFpEF signifies symptomatic disease 1.Diagnosis
Management
In patients with sinus rhythm (SR), maintaining heart rates <77 bpm during the vulnerable period (1-3 months post-discharge) is associated with reduced mortality 1.
In patients with atrial fibrillation (AF), maintaining heart rates <71 bpm during the vulnerable period is associated with reduced HF readmission and/or mortality 1.
Higher heart rates (>94 bpm in SR) are associated with increased mortality risk 1.
Heart rates between 77-129 bpm in SR patients are associated with increased HF readmission and composite outcomes 1.Special Populations
Key Recommendations
Maintain heart rates <77 bpm in patients with sinus rhythm during the vulnerable period post-discharge to reduce readmission and mortality 1. (Evidence: Moderate)
Maintain heart rates <71 bpm in patients with atrial fibrillation during the vulnerable period post-discharge to reduce readmission and mortality 1. (Evidence: Moderate)References
1 Xu M, Shi P, Feng Y, Zhang W, Gao D. Rhythm-specific heart rate thresholds during the vulnerable period: integrated analysis for prognostic optimization in heart failure. European journal of medical research 2025. link