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(Circulation. 2006;113:1922-1925.)
© 2006 American Heart Association, Inc.

Editorial

New Molecular Mechanism in Diastolic Heart Failure

Arnold M. Katz, MD; Michael R. Zile, MD

From the University of Connecticut School of Medicine, Farmington, Conn, and Dartmouth Medical School, Lebanon, NH (A.M.K.); and the Division of Cardiology and the Gazes Cardiac Research Institute, Department of Medicine, Medical University of South Carolina and RHJ Department of Veterans Affairs Medical Center, Charleston, SC (M.R.Z.).

Correspondence to Arnold M. Katz, MD, 1592 New Boston Rd, PO Box 1048, Norwich, VT 05055-1048. E-mail arnold.m.katz@dartmouth.edu

Key Words: Editorials • diastole • heart failure • titin • cytoskeleton

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
In contrast to systolic heart failure (SHF), for which knowledge of pathophysiology and therapy has advanced rapidly over the past decade, little is known about diastolic heart failure (DHF). The article by van Heerebeek et al¹ in this issue of Circulation that describes an abnormal distribution of titin isoforms in DHF may herald a new approach to understanding the pathophysiology of this syndrome.

Article p 1966

Recognition of 2 forms of heart failure is not new; almost 70 years ago, Fishberg² described "those forms of cardiac insufficiency which are due to inadequate diastolic filling of the heart (hypodiastolic failure) [and] the far more common ones in which the heart fills adequately but does not empty to the normal extent (hyposystolic failure)" (p 23). This distinction has stood the test of time, because there is a growing consensus that these 2 clinical syndromes differ in epidemiology, demographics, and origin. Because DHF and SHF represent subgroups of patients with heart failure, they share many clinical features, notably the hemodynamic findings, but it is now clear that they are caused by different pathophysiological mechanisms. Hearts in SHF are characterized by eccentric hypertrophy, progressive left ventricular (LV) dilation, and abnormal LV systolic properties, whereas in DHF, the hearts generally exhibit concentric hypertrophy, normal or reduced LV volume, concentric remodeling, and abnormal diastolic function.^3,4 In addition, cardiomyocyte size, shape, and molecular composition differ in these 2 syndromes.

	Diastolic Dysfunction and DHF

 
Diastolic dysfunction refers to mechanical and functional abnormalities present during relaxation and filling, whereas DHF refers to clinical . . . [Full Text of this Article]

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