What is diastolic dysfunction ? It is excessive stiffness of the heart resulting in an inability of the heart to fill properly (Eur Heart J 1998; 19: 990-1003). This is in contrast to systolic dys-function, where contractility is impaired. Patients have clinical features of left heart failure but normal systolic function by echocardiography or radionuclide ven-triculography. It is a feature of hypertrophic cardiomyopathy, severe left ventricular hypertrophy (e.g. aortic stenosis or hypertension) and restrictive cardiomyopathy (e.g. amyloidosis). Treatment is directed towards the underlying cause.
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