Diastolic Dysfunction: from Discovery to the Last Updates

Abstract

Over a long period, chronic heart failure was primarily associated with impaired contractility of the myocardium of the left ventricular, which is a manifestation of systolic dysfunction. Based on modern ideas about the pathophysiology of CHF syndrome, systolic dysfunction is considered as one of the etiological factors along with changes in wall tension and the structure of diastolic filling, i.e. everything that is included in the concept of "LV remodeling". The objective is to present a review of the key parameters of chronic heart failure and left ventricular diastolic dysfunction according to the last updates. Material and methods. The role and significance of diastolic dysfunction as the cause of chronic heart failure syndrome, have only been started to be determined over the past three decades, which can be explained by the difficulty of early diagnostics of diastolic dysfunction. The article describes the historical evolution of estimating heart failure and left ventricular diastolic dysfunction. It is important to note the high prevalence of diastolic dysfunction. The signs of myocardial diastolic dysfunction are detected in people with almost any heart disease. The universal review of the most important parameters which determine this disorder has been presented. It has been shown that nowadays Doppler echocardiography is the noninvasive “golden standard” for estimation of diastolic dysfunction. We have presented methods of treatment for diastolic dysfunction, based on updated recommendations of the American College of Cardiology / American Heart Association in treating patients with heart failure in 2017. Conclusions. The experimental studies show that the survival rate of patients with heart failure with a preserved ejection fraction depends not so much on its indices, but on the severity of diastolic dysfunction. Diastolic dysfunction in patients with heart failure is a more prognostic mortality rate than the ejection fraction, which needs further research for better treatment.