Diastolic dysfunction of the left ventricle of the heart. Description. Treatment

Diastolic dysfunction of the left ventricle of the heart is a decrease in its ability to pump blood into its cavity from the pulmonary arterial system. The causes of this phenomenon are mostly based on a drop in the ductility of the walls. The signs of diastolic dysfunction of the left ventricle are manifested in an increase in the ratio of the final pressure to the final volume.

Stages of filling

Stages of diastolic filling in the left ventricle include relaxation, passive filling and filling by contraction in the atria. Relaxation is an active transport of calcium ions from actin-myosin filaments. On the basis of ischemia, inhibition of the excretion of ions occurs, as a result of which relaxation becomes insufficient. With a decrease in filling, arterial and venous hypertension, night paroxysmal dyspnea, cough, and dyspnea are noted. Passion follows passive filling. The determinant of the blood volume in this case is considered the compliance of the walls of the ventricle, with a decrease in which the passive filling decreases. The active contraction of the atrium walls causes the entry of 15-20% of the diastolic final volume. Rigidity of the walls provokes an increase in the incoming volume. With ischemia and pathological rigidity, atrial fibrillation significantly increases the risk of cardiogenic edema in the lungs.

Diastolic dysfunction of the left ventricle. Causes

The main provoking factors include infiltrative diseases at the level of the heart of the system type (amyloidosis and others), hypertension, accompanied by hypertrophy in the left ventricle. Among the reasons, experts also note hypertrophic cardiomyopathy.

Diastolic dysfunction of the left ventricle. Treatment

Experts note that theoretically, the improvement should be influenced by drugs that reduce LV hypertrophy, which increase active relaxation and improve its compliance. Diastolic dysfunction of the left ventricle is corrected by calcium antagonists and angiotensin-converting enzyme inhibitors. Data on beneficial effects are obtained in most patients. There is a very positive effect of such, for example, the means, as "Enalapril". Diastolic dysfunction of the left ventricle lends itself to therapy in a fairly short time. So, usually after eight to sixteen weeks, there has already been an improvement. These results are observed even before the onset of statistically significant regression of hypertrophy in the LV. The effect on the improvement of heart function is of practical importance in the selection of therapy in patients with arterial hypertension and in cardiac failure in chronic course. Specialists note the effectiveness of ACE inhibitors in the early stages, including in the asymptomatic course of disorders, as well as in the late stages of decompensation. In the treatment, any preparation of the specified group can be assigned, however, preference is given to the means, the effectiveness of which has been verified experimentally. Thus, there is a significant improvement in diastolic function when patients receive Lizinopril therapy.