Confused about Stiff Heart, Diastolic Heart Failure, or HFpEF?

Posted by Kanaaz Pereira, Connect Moderator @kanaazpereira, Fri, Jan 18 5:03pm

Nearly half of all patients with heart failure have a normal EF or ejection fraction. EF is a percentage of how much blood the left ventricle pumps out with each contraction. Why is that?

To get some answers, and with Valentine’s Day just around the corner (what better way to celebrate than by learning about your heart), we sat down with Mayo Clinic cardiologist and heart failure specialist, Dr. Farris Timimi. In this video, Dr. Timimi explains the phenomenon of heart failure with preserved ejection fraction or HFpEF.

Do you have heart failure with preserved ejection fraction (sometimes called Stiff Heart or Diastolic Heart Failure)? What limitations have you experienced with a HFpEF diagnosis? What has helped you?

@kanaazpereira

Hi @barbarajane @cynaburst @cynthiamary @lynnkay1956 @medic7054 @evelyn247 @c410djh @jigglejaws94 @thankfulalways @mpeters @sammysky @bjanderson @jwoj @brittalisse @pfazenbaker @pepper1311 @predictable @thankful @hopeful33250 @harmonybentley @mzhp1988 @lioness @wangs @gibbs @soloact,

I’d like to invite you to join this discussion about heart failure with preserved ejection fraction or HFpEF – also known as stiff heart or diastolic heart failure. Share your experiences, ask questions, and let’s support and learn more from each other. Please drop a note to say hi and introduce yourself.

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@kanaazpereira Thank you for inviting. I only had a triple by pass in 1996 and since then I have had no major problems with my heart I am on Losartan 100 mg for my Blood Pressure and Pravastatin for my cholesterol .Just had a angiogram and heart vessels are all intact .Have always ate healthy and my cardio surgeon told me no more red meat so I still don't eat red meat .Exercising all my life nothing strenuous now at 76 I started a chair exercise program using You tube videos

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@bjanderson

Hi Hopeful. I do have a website for you. It is:
http://www.sciencedaily.com/releases/2018/02/180207164033.htm
I did reread it and found the drug is being studied for muscular dystrophy also. It is not yet being used. Let’s hope it comes to fruition.

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@hopeful33250 A lot of drugs are good for alot of different diseases .Havecyou listened to Dr. Terry Wahl the video that John sent she had M.S. and a Dr. so she is now back to work and MS free very interesting video .If I can find it I,ll send it or John may know where its at.

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Sometimes my Systolic number is a whole lot higher than my Diastolic. Like: 145/58. Does that mean I have a stiff heart?

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Thank you for sharing this excellent video. Would individuals with diastolic failure have low/high diastolic values?

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Today I heard Dr. Farris Timimi explain "Heart Failure with Preserved Ejection Fraction". This is the state of my heart. I have diastolic dysfunction. The symptom that led me to this diagnosis, at Mayo Clinic, is shortness of breath when walking for one mile. TRIAMTERENE/HCTZ 37.5-25MG CAP was prescribed.
My concern is whether or not exercise harms the heart that has diastolic dysfunction. I am interested in learning the type and amount of exercise that is appropriate for someone in the early stages of diastolic dysfunction. I also wonder if a hard pounding of each beat of the heart, which I have intermittently even when sitting, is related to diastolic dysfunction.
Thank you.
@muriel66

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"My concern is whether or not exercise harms the heart that has diastolic dysfunction. I am interested in learning the type and amount of exercise that is appropriate for someone in the early stages of diastolic dysfunction. I also wonder if a hard pounding of each beat of the heart, which I have intermittently even when sitting, is related to diastolic dysfunction."
These are my questions too. I have asked my PCP and my cardiologist. They don't seem to know.

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@mzhp1988

"My concern is whether or not exercise harms the heart that has diastolic dysfunction. I am interested in learning the type and amount of exercise that is appropriate for someone in the early stages of diastolic dysfunction. I also wonder if a hard pounding of each beat of the heart, which I have intermittently even when sitting, is related to diastolic dysfunction."
These are my questions too. I have asked my PCP and my cardiologist. They don't seem to know.

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There is good data that suggests regular, moderate aerobic activity is helpful for patients with diastolic heart failure.

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@muriel66

Today I heard Dr. Farris Timimi explain "Heart Failure with Preserved Ejection Fraction". This is the state of my heart. I have diastolic dysfunction. The symptom that led me to this diagnosis, at Mayo Clinic, is shortness of breath when walking for one mile. TRIAMTERENE/HCTZ 37.5-25MG CAP was prescribed.
My concern is whether or not exercise harms the heart that has diastolic dysfunction. I am interested in learning the type and amount of exercise that is appropriate for someone in the early stages of diastolic dysfunction. I also wonder if a hard pounding of each beat of the heart, which I have intermittently even when sitting, is related to diastolic dysfunction.
Thank you.
@muriel66

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In general, a good rule of thumb is to exercise at 60% of your aerobic capacity-the easy way to tell is to exercise at a level that you can still speak in a seven word sentence.

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@bjh369

Sometimes my Systolic number is a whole lot higher than my Diastolic. Like: 145/58. Does that mean I have a stiff heart?

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No-it can suggest a risk but not a diagnosis.

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@FarrisTimimi

In general, a good rule of thumb is to exercise at 60% of your aerobic capacity-the easy way to tell is to exercise at a level that you can still speak in a seven word sentence.

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I am new to this conversation and to my diagnosis of Heart Failure with Preserved Ejection Fraction. I came from Florida to Mayo Minnesota and received my diagnosis. Best care at Mayo/MN I have ever received and I have been in the health care field for over 40 years. Before coming to Mayo, I started pulmonary rehab. My cardiologist ordered it because she said my problem was pulmonary, not cardiac. That did not prove to be true, but it was the so helpful because in pulmonary rehab you are closely monitored and told to 'be the turtle', taking your time and doing the exercises correctly. I did all the same exercises I had been doing before, but I did them slower and rested in between. I could do the exercises and weight lifting under supervision and my shortness of breath has been substantially reduced. I now have my home set up like the rehab and slowly stay active. I hope this helps someone as we each need to find what works best for us.

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@FarrisTimimi

There is good data that suggests regular, moderate aerobic activity is helpful for patients with diastolic heart failure.

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Thank you!

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@FarrisTimimi

There is good data that suggests regular, moderate aerobic activity is helpful for patients with diastolic heart failure.

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I do exercise on a regular basis, but cannot do it daily because of the tremendous fatigue that accompanies exercise, @FarrisTimimi. Might this indicate that my heart meds need to be changed or is this typical? I also met with my endocrinologist recently who said that my magnesium level was at the low normal range (1.8) and that it was possible that when I exercise I go below the normal range and that causes muscle fatigue. I suppose that would affect the heart muscle as well? I have no edema.

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@muriel66

Today I heard Dr. Farris Timimi explain "Heart Failure with Preserved Ejection Fraction". This is the state of my heart. I have diastolic dysfunction. The symptom that led me to this diagnosis, at Mayo Clinic, is shortness of breath when walking for one mile. TRIAMTERENE/HCTZ 37.5-25MG CAP was prescribed.
My concern is whether or not exercise harms the heart that has diastolic dysfunction. I am interested in learning the type and amount of exercise that is appropriate for someone in the early stages of diastolic dysfunction. I also wonder if a hard pounding of each beat of the heart, which I have intermittently even when sitting, is related to diastolic dysfunction.
Thank you.
@muriel66

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I’ve been told to exercise 6 days per week. I usually manage 5-6 days and I walk 1 1/2 miles at 3 mph. I can do arm exercises with 3-5 lb. weights but no more than that. Consult with your Dr. first, of course. I was diagnosed 4 years ago and it all began with Afib. The heart pounding i’m not sure about. Hope this helps!!

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@hopeful33250

I do exercise on a regular basis, but cannot do it daily because of the tremendous fatigue that accompanies exercise, @FarrisTimimi. Might this indicate that my heart meds need to be changed or is this typical? I also met with my endocrinologist recently who said that my magnesium level was at the low normal range (1.8) and that it was possible that when I exercise I go below the normal range and that causes muscle fatigue. I suppose that would affect the heart muscle as well? I have no edema.

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I would encourage you to discuss this with your provider.

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Research studies have shown that Entresto may help improve HFpEF. I thought you might be interested in learning more about this clinical trial from Mayo Clinic, which is open for participation: https://clinicaltrials.gov/ct2/show/NCT03506412
The NIH-funded trial will evaluate the the efficacy of Entresto in patients who’ve been diagnosed with a stiff heart.

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