Diastolic dysfunction overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Congestive heart failure and cardiac dysfunction are not interchangeable definitions. Whereas heart failure is a clinical definition that illustrates the occurrence of symptoms of fatigue, dyspnea, and fluid overload; cardiac dysfunction is a mechanical definition that includes abnormalities in heart contraction ( called systolic dysfunction) or abnormalities in heart relaxation and filling ( called diastolic dysfunction) or both.[1]

Therefore, diastolic dysfunction refers to a mechanical dysfunction of the heart during the diastolic phase of the cardiac cycle in the presence or absence of any clinical symptoms. When clinical symptoms are present on top of the mechanical dysfunction of the heart, the condition is called diastolic heart failure.[2]

Diastole is the phase of the cardiac cycle when the heart ( i.e. ventricle) is not contracting but is actually relaxed and filling with blood that is being returned to it, either from the body (into right ventricle) or from the lungs ( into left ventricle). The mechanical abnormality in diastolic dysfunction is characterized by a decrease in the ventricular filling in the context of an elevated left ventricular end diastolic pressure and a normal ejection fraction.

Diastolic dysfunction is caused by decrease cardiac muscle relaxation or increased stiffness.

Systolic and diastolic dysfunction commonly occur in conjunction with each other.

References

  1. Zile, Brutsaert. New Concepts in Diastolic Dysfunction and Diastolic Heart Failure: Part I. Circulation. 2002; 105: 1387-1393
  2. Zile, Brutsaert. New Concepts in Diastolic Dysfunction and Diastolic Heart Failure: Part I. Circulation. 2002; 105: 1387-1393

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