Targeting Preclinical Diastolic Dysfunction to Prevent Heart Failure: Contemporary Insights

Diastolic dysfunction encompasses both those who are asymptomatic and those who have heart failure symptoms. Preclinical diastolic dysfunction (PDD), defined as diastolic dysfunction with preserved ejection fraction (EF) without the presence of heart failure symptoms, is prevalent and may progress to heart failure with preserved EF (HFpEF). While the causative factors of HFpEF are multifactorial, targeting PDD and its associated comorbidities prior to development of symptoms can reduce development of heart failure. Diabetes, coronary artery disease, hypertension, and renal dysfunction are targets of treatment in those with diastolic dysfunction that may decrease the risk of heart failure development. This review will focus on PDD, its epidemiology, pathophysiology, comorbid conditions, and management that may prevent development of heart failure.