• Diastolic Dysfunction

    by  • 20/08/2013 • Cardiology

    Stiff ventricle = inadequate filling = reduced SV/CO and increased end diastolic volume (inefficient)!

    Heart failure caused by diastolic dysfunction is generally described as the failure of the ventricle to adequately relax and typically denotes a stiffer ventricular wall. This causes inadequate filling of the ventricle, and therefore results in an inadequate stroke volume. The failure of ventricular relaxation also results in elevated end-diastolic pressures

    Diastolic dysfunction can be caused by processes similar to those that cause systolic dysfunction, particularly causes that affect cardiac remodeling.

    Diastolic dysfunction may not manifest itself except in physiologic extremes if systolic function is preserved. The patient may be completely asymptomatic at rest.

    Can be very sensitive to raised/irregular heart rhythms = risk of flash pulmonary oedema

    Left ventricular diastolic function can be determined through echocardiography by measurement of various parameters such as the E/A ratio (early-to-atrial left ventricular filling ratio), the E (early left ventricular filling) deceleration time, and the isovolumic relaxation time

    The future:

    As HF progresses, contractility reduced, CO reduced, CVP and BP increased to compensate (via RAA and salt and water retention) and sympathetic vasoconstriction and increased HR. Eventually, CVP/BP cannot increase anymore, therefore CO reduces greatly, heart dilates, valves fail = death! 

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