Diastolic Function of the Heart in Clinical Cardiology

Harizi, Robert; Bianco, Jesus A.; Alpert, Joseph S.

doi:10.1001/archinte.1988.00380010103010

Cited by 114 publications

(21 citation statements)

References 94 publications

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“…Myocardial ischemia causes decreased compliance, increasing the left ventricular filling pressure at a given end-diastolic volume (25). Compensatory increases in left ventricular volumes to maintain stroke volume further increase filling pressures.…”

Section: Myocardial Pathologymentioning

confidence: 99%

Cardiogenic Shock

1999

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Section: Myocardial Pathologymentioning

confidence: 99%

Cardiogenic Shock

1999

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“…When diastolic dysfunction occurs, there is an abnormal diastolic pressure‐volume relationship with impaired capacity of the ventricle to accept blood or fill without an abnormal increase in atrial and ventricular filling pressures 9,10 . Such dysfunction may affect only early rapid filling phases, which are dependent on active ventricular relaxation; or the dysfunction may affect filling throughout entire diastole, including the later phase, which is considered to be a passive phenomena related mainly to ventricular stiffness and distensibility 11,12 .…”

Section: Pathophysiologymentioning

confidence: 99%

Heart Failure with Normal Systolic Function: A Common Disorder in Older People

Tresch¹,

McGough²

1995

J American Geriatrics Society

140

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Diastolic ventricular dysfunction is a significant problem in older people, with at least 40% of older heart failure patients having diastolic dysfunction as the etiology of their heart failure. The pathophysiology of diastolic dysfunction is varied but usually involves impaired left ventricular relaxation and/or increased ventricular stiffness, each partially related to normal aging changes, as well as underlying cardiovascular diseases. The significance of heart failure caused by diastolic dysfunction is great, with increased morbidity and mortality compared with other cardiac diseases that have the same preserved systolic function. Diagnosis of diastolic dysfunction can be clinically difficult and often requires further testing to determine if diastolic dysfunction is present. At this time, no therapy specifically treats diastolic dysfunction, but several medications, such as diuretics, calcium channel blockers, beta blockers, and angiotension-converting enzyme inhibitors, offer symptomatic relief and may prevent progression of the disorder.

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“…This would agree with findings that impaired diastolic performance may be an early functional abnormality of the heart in hypertension. 37 Tachycardia is a reliable sign of mental arousal in humans and occurs even in very mild defense reactions.' It is of interest, therefore, to note that the verbal instructions preceding the forced mental arithmetics (i.e., a mild form of stress) elevated heart rate in the hypertensive group only.…”

Section: Mental Stressmentioning

confidence: 99%

Stress‐induced changes in blood pressure and left ventricular function in mild hypertension

Lindvall

Kahan

et al. 1991

Clinical Cardiology

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Summary:Left ventricular function was studied by Mmode echocardiography at rest and during a mental arithmetic stress test and a cold-pressor test in 14 patients with mild hypertension and in 14 matched normotensive subjects. The elevation of blood pressure at rest in the hypertensive group (154+4/87+3 vs. 120+3/66+3 mmHg in the control group) was due mainly to a higher cardiac output (6.030.3 vs. 5.0+0.3 L/min), which was related to elevations of stroke volume and heart rate (73+2 vs. 66 + 2 beatdmin). Venous plasma catecholamines were similar in the two groups. Mental stress induced cardiac output-dependent increases in blood pressure in both groups; systemic vascular resistence tended to decrease. The relative increases in diastolic and mean arterial blood pressure were smaller in the hypertensive group (IS vs. 26% and 15 vs. 21 %, respectively), which exhibited signs of a reduced cardiac compliance, possibly related to a left ventricular hypertrophy. Mental stress elevated venous plasma adrenaline similarly in the two groups; effects on noradrenaline were small. The cold-pressor test increased blood pressure similarly in the two groups, largely due to increased systemic vascular resistence; plasma noradrenaline responses were also similar. Mental stress appears to elicit a differentiated sympathetic nerve acti- vation pattern resembling the hypothalamic defense reaction. Mild hypertension seems to be associated with increased arousal and cardiac activation at rest. However, an attenuated blood pressure reactivity to mental stress may reflect reduced stroke volume responsiveness, which is related to structural changes, as heart rate reactivity tended to be enhanced in mild hypertension.

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Diastolic Function of the Heart in Clinical Cardiology

Cited by 114 publications

References 94 publications

Cardiogenic Shock

Cardiogenic Shock

Heart Failure with Normal Systolic Function: A Common Disorder in Older People

Stress‐induced changes in blood pressure and left ventricular function in mild hypertension

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