Current perspectives in diastolic dysfunction and diastolic heart failure

Except for heart rate these other determinants are extrinsic to the ventricle and therefore normally not considered as true causes of ventricular diastolic dysfunction or failure. [...]diagnosis of diastolic HF implies exclusion of these determinants as the cause of ventricular filling disturbances....

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Bibliographic Details
Published in:Heart (British Cardiac Society) 2006-05, Vol.92 (5), p.712-718
Main Author: Leite-Moreira, Adelino F
Format: Article
Language:English
Subjects:
Adenosine
Biological and medical sciences
Cardiology. Vascular system
Cardiovascular disease
Cytoskeleton
Diastole - physiology
diastolic dysfunction
diastolic heart failure
Drug dosages
Education in Heart
Electrocardiography
Extracellular matrix
Geometry
Heart
Heart failure
Heart Failure - diagnosis
Heart Failure - physiopathology
Heart Failure - therapy
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Heart rate
Heart Rate - physiology
Homeostasis
Humans
Hypertension
Medical sciences
Mortality
Myocardial Contraction - physiology
Prognosis
Proteins
Ventricular Dysfunction, Left - diagnosis
Ventricular Dysfunction, Left - physiopathology
Ventricular Dysfunction, Left - therapy
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Summary:Except for heart rate these other determinants are extrinsic to the ventricle and therefore normally not considered as true causes of ventricular diastolic dysfunction or failure. [...]diagnosis of diastolic HF implies exclusion of these determinants as the cause of ventricular filling disturbances. 3 Table 1 Determinants of diastolic function * Myocardial relaxation - load - inactivation (calcium homeostasis, myofilaments, energetics) - non-uniformity * Passive properties of ventricular wall - myocardial stiffness (cytoskeleton, extracellular matrix) - wall thickness - chamber geometry * Other determinants - structures surrounding the ventricle (pericardium, lungs, remaining cardiac chambers) - left atrium, pulmonary veins and mitral valve - heart rate Relaxation Relaxation is the process whereby the myocardium returns to an unstressed length and force. [...]calcium channel blockers have no place in the treatment of systolic HF, but have been considered potentially useful in the treatment of diastolic HF. 9 Conceptually, an ideal therapeutic agent should target the underlying mechanisms that cause diastolic HF. [...]a therapeutic agent might improve calcium homeostasis and energetics, blunt neurohumoral activation and decrease myocardial stiffness.
ISSN:1355-6037
1468-201X
DOI:10.1136/hrt.2005.062950