Zaporožskij Medicinskij Žurnal (Jul 2019)
Diastolic dysfunction: from the discovery to the latest updates
Abstract
Over a long period, chronic heart failure was primarily associated with impaired contractility of the left ventricular myocardium, which is a manifestation of systolic dysfunction. Based on modern ideas about the pathophysiology of CHF syndrome, systolic dysfunction is considered as one of the etiological factors along with changes in wall tension and the structure of diastolic filling, i.e. everything that is included in the concept of “LV remodeling”. The objective is to present a review of the key parameters of chronic heart failure and left ventricular diastolic dysfunction according to the latest updates. The role and significance of diastolic dysfunction as the cause of chronic heart failure syndrome have only been determined over the past three decades, which can be explained by the difficulty of early diagnostics of diastolic dysfunction. The article describes the historical evolution of heart failure and left ventricular diastolic dysfunction estimation. It is important to note the high prevalence of diastolic dysfunction. The signs of myocardial diastolic dysfunction are detected in people with almost any heart disease. The universal review of the most important parameters which determine this disorder has been presented. It has been shown that Doppler echocardiography is now the noninvasive “gold standard” for estimation of diastolic dysfunction. We have presented methods of treatment for diastolic dysfunction according to the 2017AmericanCollegeof Cardiology/American Heart Association updated Guidelines for the management of heart failure Conclusions. The experimental studies demonstrate that the survival of HF patients with a preserved EF depends not so much on its indices, but on the severity of DD. DD is a more prognostic marker of mortality rate in patients with HF than EF, which requires further study for better therapeutic efficacy.
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