Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic aspects
<p>Abstract</p> <p>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 involve relaxation and/or filling and/or distensibility. Arterial hypertension...
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| Format: | Article |
| Language: | English |
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BMC
2005-04-01
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| Series: | Cardiovascular Ultrasound |
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| Online Access: | http://www.cardiovascularultrasound.com/content/3/1/9 |
| _version_ | 1828942974325620736 |
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| author | Galderisi Maurizio |
| author_facet | Galderisi Maurizio |
| author_sort | Galderisi Maurizio |
| collection | DOAJ |
| description | <p>Abstract</p> <p>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 involve relaxation and/or filling and/or distensibility. Arterial hypertension associated to LV concentric remodelling is the main determinant of DD but several other cardiac diseases, including myocardial ischemia, and extra-cardiac pathologies involving the heart are other 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 position of 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. In relation to uncertain definitions, both prevalence and prognosis of diastolic heart failure are very variable. 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. Recent studies performed by Doppler diastolic indexes have identified the prognostic power of both transmitral E/A ratio < 1 (pattern of abnormal relaxation) and > 1.5 (restrictive patterns). The therapy of LV DD and HF is not well established but ACE-inhibitors, angiotensin inhibitors, aldosterone antagonists and β-blockers show potential beneficial effect on diastolic properties. Several trials, completed or ongoing, have been planned to treat DD and diastolic HF.</p> |
| first_indexed | 2024-12-14T04:05:38Z |
| format | Article |
| id | doaj.art-2e6f836d59f44d75af150f8f83d739db |
| institution | Directory Open Access Journal |
| issn | 1476-7120 |
| language | English |
| last_indexed | 2024-12-14T04:05:38Z |
| publishDate | 2005-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Ultrasound |
| spelling | doaj.art-2e6f836d59f44d75af150f8f83d739db2022-12-21T23:17:49ZengBMCCardiovascular Ultrasound1476-71202005-04-0131910.1186/1476-7120-3-9Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic aspectsGalderisi Maurizio<p>Abstract</p> <p>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 involve relaxation and/or filling and/or distensibility. Arterial hypertension associated to LV concentric remodelling is the main determinant of DD but several other cardiac diseases, including myocardial ischemia, and extra-cardiac pathologies involving the heart are other 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 position of 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. In relation to uncertain definitions, both prevalence and prognosis of diastolic heart failure are very variable. 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. Recent studies performed by Doppler diastolic indexes have identified the prognostic power of both transmitral E/A ratio < 1 (pattern of abnormal relaxation) and > 1.5 (restrictive patterns). The therapy of LV DD and HF is not well established but ACE-inhibitors, angiotensin inhibitors, aldosterone antagonists and β-blockers show potential beneficial effect on diastolic properties. Several trials, completed or ongoing, have been planned to treat DD and diastolic HF.</p>http://www.cardiovascularultrasound.com/content/3/1/9Diastolic dysfunctionDiastolic heart failureLeft ventricleCardiac catheterizationDoppler echocardiography |
| spellingShingle | Galderisi Maurizio Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic aspects Cardiovascular Ultrasound Diastolic dysfunction Diastolic heart failure Left ventricle Cardiac catheterization Doppler echocardiography |
| title | Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic aspects |
| title_full | Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic aspects |
| title_fullStr | Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic aspects |
| title_full_unstemmed | Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic aspects |
| title_short | Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic aspects |
| title_sort | diastolic dysfunction and diastolic heart failure diagnostic prognostic and therapeutic aspects |
| topic | Diastolic dysfunction Diastolic heart failure Left ventricle Cardiac catheterization Doppler echocardiography |
| url | http://www.cardiovascularultrasound.com/content/3/1/9 |
| work_keys_str_mv | AT galderisimaurizio diastolicdysfunctionanddiastolicheartfailurediagnosticprognosticandtherapeuticaspects |