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Continuing Education in Anaesthesia, Critical Care & Pain 2009 9(1):29-33; doi:10.1093/bjaceaccp/mkn046
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© The Board of Management and Trustees of the British Journal of Anaesthesia [2009]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Diastolic dysfunction

Rik Kapila, FRCA
Specialist Registrar in Anaesthesia
Queen's Medical Centre
Nottingham University Hospitals NHS Trust
Derby Road
Nottingham NG7 2UH
UK

Ravi P. Mahajan, DM FRCA
Professor of Anaesthesia and Intensive Care
University Division of Anaesthesia and Intensive Care
Queen's Medical Centre
Nottingham University Hospitals NHS Trust
Derby Road
Nottingham NG7 2UH
UK
Tel: +44 115 8231009 E-mail: ravi.mahajan@nottingham.ac.uk

The first 150 words of the full text of this article appear below.


Key points

Lusitropy (early diastolic relaxation) is an active, ATP-dependent process.
Diastolic dysfunction (DD) results from abnormalities in relaxation and filling.
DD is often asymptomatic.
Doppler echocardiography provides a reliable, non-invasive technique for diagnosis and staging.
Measures of flow, pressure, and tissue motion are indices of diastolic function.
Distinguishing diastolic heart failure (DHF) from systolic heart failure (SHF) is important because of differences in treatment and prognosis.

 

Diastolic dysfunction (DD) is increasingly being recognized as an important cause of heart failure. Often the condition may not be anticipated and difficult to differentiate from systolic dysfunction when symptoms develop. This article describes the pathophysiology, clinical features, diagnosis, and management of the condition.


   Pathophysiology
 
Diastole (Fig. 1) is the period of the cardiac cycle between closure of the aortic valve and that of the mitral valve. During this time, the left ventricle (LV) relaxes and refills, ready for the next systolic contraction. . . . [Full Text of this Article]

Cellular mechanisms


   Clinical manifestations
 

   Diagnosis
 
Echocardiography


   Treatment
 
Pharmacological

Hypertension

Chronic AF

Coronary artery disease

Volume overload

Other therapies

Non-pharmacological


   Prognosis
 

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