Diagnosis of diastolic dysfunction in the emergency department: really at reach for minimally trained sonologists? A call for a wise approach to heart failure with preserved ejection fraction diagnosis in the ER

摘要

In developed countries heart failure represents a heavyepidemiological burden, with a prevalence of 1–2% ofthe adult population, rising to ≥10% among people with70 years of age [1, 2]. Diastolic heart failure (HeartFailure with preserved Ejection Fraction, HFpEF [2])accounts for a relevant proportion of all HF admissions,ranging from 22 to 70% according to its defnition, setting,population age and sex, with the highest prevalencein the elderly. Furthermore, among people 65 years ofage presenting to primary care with breathlessness onexertion, one in six will have unrecognized HF (mainlyHFpEF) [3]. In patients with HFpEF, there is a strongassociation between prognosis and the underlying heartfailure etiology, but overall mortality is estimated as highas 5–10% [4]. Tese data overall compel an accurate andearly diagnostic strategy for HFpEF since its presentationin the emergency department, and early bedside ultrasoundundoubtedly has the potential to comply with thisneed [5].