Diastolic Heart Failure Otto A. Smiseth (Editor), Michal Tendera (Editor)
Publisher: Springer
ISBN: 1846288908
DDC: 616.129
Edition: Hardcover; 2007-12-12
Summary:
Heart failure is the biggest killer in the western world, and the
prevalence is expected to increase due to aging of the population.
Over the past decade there has been an increasing awareness of left
ventricular (LV) diastolic dysfunction as a mechanism of congestive
heart failure, and it appears that more than 30-40 % of all heart
failure patients have dominantly diastolic heart failure, with
preserved or only mildly reduced systolic function. Recent clinical
studies suggest that patients with congestive heart failure and
preserved LV function may benefit from specific medical treatment.
Furthermore, in patients with hypertension the presence of diastolic
dysfunction is a sign that the myocardium has reacted to the elevated
blood pressure, and might indicate the need for intensified
antihypertensive therapy. In spite of all this there are very few
textbooks that provides the knowledge that would be needed in
cardiology practice to approach and deal with patients with diastolic
heart failure. There is, however, significant disagreement regarding
the clinical value of assessing diastolic function, and the
practising cardiologist is confused by the non-invasive methodology
which includes a myriad of Doppler-based indices, and most of these
are strongly dependant on age and cardiac loading conditions. Recent
advances in non-invasive cardiac diagnostics, and in particular
tissue Doppler echocardiography provides better and simpler
diagnostic algorithm. However, in order to interpret the diagnostic
methods the cardiologist should understand some fundamental concepts
which relate to the physiology of cardiac filling. Current literature
suggests that assessment of diastolic function may be clinically
useful to make the diagnosis diastolic heart failure in patients who
present with congestive heart failure and normal LV ejection
fraction, and to provide a non-invasive estimate of LV diastolic
pressure. Quantification of diastolic function also provides
prognostic information that may be important. Furthermore, assessment
of diastolic filling is very useful in the evaluation of patients
suspected of constrictive pericarditis and in differentiating between
constriction and restriction.
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