الفهرس 
ETIOLOGYOnly 14 pages are availabe for public view
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Abstract
Left ventricular (LV) diastolic dysfunction (DD) and diastolic heart failure (HF), that is symptomatic DD, are due to alterations of myocardial diastolic properties. These alterations are a consequence of stiff left ventricle with decreased compliance and impaired relaxation, which leads to impaired filling of the heart and increased end diastolic pressure. Arterial hypertension and subsequent left ventricular concentric remodeling is the main determinant of DD but several other cardiac diseases, including myocardial ischemia, diabetes and obesity constitute possible causes. In the majority of the studies, isolated diastolic HF has been made equal to HF with preserved systolic function (= normal ejection fraction) but the true definition of this condition needs a quantitative estimation of LV diastolic properties. According to the European Society of Cardiology and subsequent research refinements the use of Doppler echocardiography (transmitral inflow and pulmonary venous flow) and the new ultrasound tools has to be encouraged for diagnosis of DD. Despite an apparent lower death rate in comparison with LV systolic HF, long-term follow-up (more than 5 years) show similar mortality between the two kinds of HF. The therapy of LV DD and HF is not well established but ACE-inhibitors, angiotensin inhibitors, aldosterone antagonists, β-blockers and calcium channel blockers show potential beneficial effect on diastolic properties. This review discusses the pathophysiology of diastolic dysfunction as well as its diagnosis by multiple methods. It also focuses on current pharmacotherapy of the disease as well as new challenges in treatment.
Keywords: Diastolic dysfunction, Diastolic heart failure, Left ventricle, Doppler echocardiography.