Diastolic function of the left ventricle according to type 1. Classification of diastolic cardiac dysfunction

The myocardium is the muscle tissue that envelops the heart. It provides alternate contraction and relaxation of its sections, thereby stimulating blood flow. If there is diastolic dysfunction of the myocardium, this means that the heart muscle is not able to relax, which is why insufficient blood flows into the left ventricle. At the same time, the left atrium, where blood is transported from the ventricle, tries to draw in as much blood as possible and works under increased tension. Over time, this leads to overload. The atrium increases in volume and ceases to function normally. If this state will occur over a long period of time, heart failure will soon begin to develop, posing a danger to human health and life.

Several varieties are known in medical practice.

1. Hypertrophic. This type of dysfunction is characterized by abnormally slow relaxation of the LV cardiac muscle. Very little blood enters the ventricle, which contributes to increased work of the atrium, due to which the required volume of blood is taken. In this case we're talking about about type 1 diastolic myocardial dysfunction.
2. Pseudonormal. Here the ventricle relaxes even more slowly than in the previous case. In this case, the ventricle does not relax completely. Observed high blood pressure in the atria. Doctors assess this pathology to be of moderate severity.
3. Restrictive. Characterized even more high performance pressure in the atrium, refers to severe forms of dysfunction. The prognosis in this case is worse than in the others, complicated by the presence of heart failure. At this stage, patients may be considered for heart transplantation.

Given the seriousness of the condition, it is important to understand the reasons for its development. This will allow you to take preventative measures to reduce the likelihood of such an illness.

Causes of dysfunction

Basically, the mechanism for the development of diastolic dysfunction of the LV myocardium looks like this: any disease provokes the development of LV myocardial hypertrophy, as a result of which thickening of the heart muscle occurs. This becomes the cause of its diastolic dysfunction.

Thus, the reasons leading to LVMH should be considered:

• arterial hypertension;
• cardiomyopathy;
• aortic stenosis.

Additional reasons for the development of the pathological condition include:

• constrictive pericarditis. Here we are talking about thickening of the pericardium, which contributes to subsequent compression of the cardiac chambers;
• primary amyloidosis. As a result of amyloid deposition, the elasticity of the heart muscle decreases, which provokes the development of its dysfunction;
• coronary artery disease. They contribute to the development of heart failure. As a result, due to numerous scar changes on the surface, the myocardium becomes more rigid and cannot perform its usual functions.

Important! Considering the fact that the load also increases on the right side of the heart, as a result of such disorders, diastolic dysfunction of both ventricles is formed.

Clinical picture

In order to be able to start treatment of the disease on time, it is necessary to carefully study the features of its manifestation. What complicates the situation is that early stages The pathology does not manifest itself in any way and is asymptomatic. When the disease reaches a more serious stage, a person begins to notice the following manifestations:

• decreased performance;
• increased fatigue;
• shortness of breath, which initially occurs with significant stress on the body, and then in a calm state;
• cough that appears when the body is lying down;
• attacks of rapid heartbeat;
• heart rhythm disturbances.

If you have any of the symptoms listed above, you should seek medical attention. medical care. The cardiologist will conduct a physical examination of the patient, collect a life history, and study the medical history. Afterwards, a diagnostic program will be drawn up to make an accurate diagnosis.

Diagnostic methods

In order to receive full information about the patient’s health status, he will be referred for the following studies:

• two-dimensional echocardiography;
• radionuclide ventriculography;
• electrocardiography;
• radiography chest.

The listed methods will allow you to evaluate structural changes in all parts of the heart, study the frequency and intensity of contraction of the organ, and obtain information about the volume of blood pumped. Doctors will also determine whether a person has signs pulmonary hypertension, which in this case is quite important.

Treatment and its methods

Initially it will be carried out drug treatment. Its program is compiled by the doctor individually for each patient, depending on the type of cardiac diseases and their severity. Typically, drugs from the following groups are used in treatment:

• adrenergic blockers – normalize heart rhythms and blood pressure, improve nutrition of the heart muscle;
• ACE inhibitors – have a similar effect to adrenoblockers, make symptoms less pronounced, eliminate signs of heart failure;
• diuretics – used in small dosages. Remove excess fluid and stabilize blood pressure. The main thing is to choose the right dosage so as not to provoke dehydration of the body and a decrease in blood volume;
• calcium antagonists – provide effective relaxation of the myocardium;
• nitrates - are used if there are signs of myocardial ischemia.

Drug treatment usually achieves good results. Surgery is recommended mainly for patients with severe forms of the disease. The decision on treatment tactics is made by the doctor after weighing all the indications and contraindications and assessing the general health of the person.

Cardiovascular diseases occupy first place among all known pathologies. Left ventricular diastolic dysfunction is a dangerous type of abnormal abnormality that is prone to complications. The disease requires professional assistance from specialists and precise implementation of prescribed therapy.

Definition of diastolic dysfunction

The pathological process is a deviation characterized by insufficient filling of the left-sided ventricle with blood during diastole, that is, the moment of relaxation of the heart muscle.

Danger of pathology

If symptomatic manifestations are ignored or recommended treatment is refused, the disease contributes to further impairment of myocardial functionality and the appearance of signs of insufficient cardiac performance of a chronic course.

For every patient pathological process takes different period– from several months to decades. Additional complications presented:

• pulmonary embolism;
• swelling of the lung tissue;
• ventricular fibrillation;
• fatal.

Distinctive features of the violation

Symptomatic manifestations of the abnormal condition are presented:

• a constantly present cough - in some cases, attacks are noted;
• paroxysmal type of dyspnea - short-term cessation of breathing during sleep;
• periodic shortness of breath.

Additional signs of the disease are:

• painful sensations in the retrosternal space - attacks resemble ischemic damage to the heart muscle;
• severe swelling of the tissues of the lower extremities;
• sharp spasms;
• feeling of insufficient oxygen supply.

Dysfunction or failure

The pathological process is characterized by a decrease in the volume of blood that enters the lower chambers of the organ. Against the background of the deviation, there is an increase in the load on the atrium - a compensatory increase in pressure indicators is observed in them, with the subsequent formation of congestion.

Violation of diastolic functionality leads to failure of the same name. In most cases, the diastolic type of heart failure is recorded with stable systolic work of the left ventricle.

The early stages of the development of the disease are dysfunctions, serious processes are classified as insufficiency.

Scheme of pathology development

Impaired functionality in the diastole phase in the left ventricle refers to age-related abnormal processes, the majority of patients are female. The disease provokes disturbances in circulatory processes and atrophic lesions of the structural elements of the myocardium.

The process of filling the heart chamber with blood includes several steps:

• complete relaxation of the muscle tissue of the organ;
• passive passage of blood into the ventricle - under the influence of differences in pressure;
• Contraction of the atria provokes the release of the remaining blood into the ventricle.

If pathological changes occur in one of the above stages, then cardiac output does not fully occur. The anomaly provokes the formation of insufficient functionality of the left-sided ventricle.

Causes of ventricular dysfunction

The main primary sources of the disease are more often found as a combination of several factors:

• elderly age;
• hypertension;
• excess body weight – with various degrees of obesity;
• arrhythmic or other disturbances in the rhythm of contractions of the heart muscle;
• fibrosis of myocardial tissue - replacement of muscle tissue with connective tissue, with a decrease in contractility and deviations in the conduction department;
• aortic stenosis;
• acute myocardial infarction.

Pathological changes in the process of blood circulation can provoke:

• thrombophlebitis;
• ischemic lesions of the heart muscle;
• constrictive pericarditis - with an increase in the volume of the outer shell of the organ and subsequent pressure on the heart chambers;
• primary amyloidosis - with a decrease in the level of myocardial elasticity, against the background of deposits of substances that cause atrophic changes;
• post-infarction cardiosclerotic lesions.

Types of pathology

The disease is divided into separate types:

Hypertrophic origin– refers to the primary stage of the lesion, often recorded in patients with early stages of arterial hypertension. Patients experience a superficial change in muscle relaxation of the left ventricle.

Pseudonormal– recorded in patients with serious deviations in the performance of the heart muscle. Against the background of the anomaly, there is a decrease in the level of muscle relaxation and an increase in pressure in the left atrium. The filling of the ventricle of the same name occurs due to the difference in pressure marks.

Restrictive– the terminal stage of dysfunction is among the most dangerous. The filling of the ventricle is minimal - against the background of a decrease in the level of elasticity of its walls and an increase in their rigidity.

Etiology

The disease is formed against the background of individual primary sources:

• arterial hypertension;
• cardiomyopathic abnormalities in the form of hypertrophy;
• periodic organ damage - myocardial infarction, ischemic disorders, chronic hypertension, hypertrophy of certain areas of the heart muscle.

Diagnosis of dysfunction

When seeking professional help, the patient undergoes a number of laboratory and instrumental examinations:

• clinical and biochemical tests blood;
• Holter monitoring;
• Ultrasound using Doppler technique;
• echocardiography.

Additional diagnostic measures are:

• determination of hormonal levels;
• X-ray images;
• coronary angiography, etc.

Therapeutic measures

Drug therapy is aimed at correcting circulatory disorders. The main goals of treatment are:

• normalization of the rhythm of organ contractions;
• stabilization of blood pressure indicators;
• restoration of water-salt metabolic processes;
• elimination of hypertrophic changes in the left ventricle.

To frequently prescribed medicines include:

• beta blockers;
• calcium antagonists;
• ACE inhibitors;
• sartans;
• diuretics;
• nitrates;
• cardiac glycosides.

Forecast

Complete cure of diastolic dysfunction of the left ventricle cannot be achieved. To prolong the patient’s life, cardiologists recommend:

• seek professional help in a timely manner;
• do not interrupt the appointment drug therapy(intended to correct problems of the circulatory system);
• pass full treatment main pathological process;
• switch to the recommended diet;
• comply with work and rest requirements.

If the above conditions are met, the prognosis becomes favorable - patients return to their usual way of life for many years.

Prevention of the disease

Specific preventive measures for the desired anomalous process has not been developed. Cardiologists recommend adhering to certain rules:

• treatment of chronic nicotine addiction;
• constant monitoring of blood pressure indicators;
• reducing the amount of table salt in the diet;
• avoidance of excess water consumption;
• control over your own body weight - if there is an excess of it, you should change the daily menu to a dietary table;
• regular exercise – to the best of your ability, without overload;
• periodic vitamin therapy;
• preventive visits to a cardiologist - at least once a year;
• refusal of alcoholic and low-alcohol products.

General activities will help improve general condition body, will bring it into adequate physical shape.

The human heart consists of several chords that prevent the valve from bending during contraction. Thanks to their presence, the organ can hold blood and push it through the vessels. In some people, in the first weeks of development, an additional chord of the left ventricle is formed. Most often it has a thread-like structure, but in some cases it is based on muscles and tendons. In 90% of cases, this abnormality is found in adolescents aged 13-16 years, but many people with this diagnosis live into old age without problems with the heart. Below we will analyze what it is and how this condition affects well-being.

Reasons for development

An additional chord in the left ventricle most often appears due to a genetic predisposition. It is transmitted in 95% of cases from mother to child. MARS develops in utero, and the catalyst for this process is a failure during the formation of connective tissue in the cavity of the left ventricle. For this reason, women who have been diagnosed with this need to have their children examined for the presence of this anomaly. Also, the reasons for the development of additional chords may be:

• poor environmental situation in the region;
• physical and nervous overstrain;
• reception alcoholic drinks and smoking.

Varieties of chords

An additional chord in the left ventricle of the heart can be of the following type:

• muscular, fibrous or fibromuscular;
• with longitudinal, transverse, diagonal connecting fibers;
• with single or multiple strands;
• median, basal or apical.

The most dangerous are the transverse chords. They can block blood flow and pose a danger to the human body. In other cases, these MARS are considered harmless and do not cause any burden on the heart.

Symptoms

The additional chord on the heart practically does not manifest itself until a certain age. With a certain structure, it may not appear even at a more mature age. It is believed that the first signs of LVDC can be detected during the active growth of the child, when the skeleton develops faster than the organs. The following symptoms may indicate the presence of MARS:

• fatigue quickly without any heavy load;
• dizziness;
• pain in the heart area;
• sudden change of mood;
• racing heartbeat.

A similar symptom complex is given not only by an additional chord in the cavity, but also by other multiple MARS. Therefore, all diagnostic work should be carried out by a doctor with extensive experience. After the active growth stage is completed, the signs of the accessory chord of the left ventricle disappear, but then appear in an adult. But a diagnosis is not made based on the symptoms listed above. The young patient will have to undergo various types diagnostics

If, after examination, a child is diagnosed with several extra chords in the heart, then the doctor should refer the patient for additional diagnostics. As is known, connective tissue in the human body it is concentrated not only near the heart, but also in the muscles and other organs. Therefore, clinical manifestations on their part may occur. If they can be detected, the child is diagnosed with connective tissue dysplasia. This disease is characterized by changes in the skeleton, muscle tissue, the structure of some organs.

Is this anomaly dangerous?

One additional chord in the heart is considered a slight deviation from the norm. Surgical treatment with this type, MARS is not required, so parents and child must remain calm. If there are no disturbances in the blood flow, then surgical and drug treatment of the disease will not be needed. As you get older, it can lead to the development of blood clots and changes in heart rhythm, but it is impossible to predict the appearance of these pathologies.

Diagnostics

The diagnosis is made after an ultrasound of the heart. The patient is first listened to for the presence of systolic murmurs. To make sure that the anomaly is harmless to the child’s body, a classic and stress ECG may be prescribed. The doctor decides which specific diagnostic methods to use after examining the patient.

Treatment

If an additional chord with symptoms of hemodynamics is detected in a child or adult, it is recommended to limit physical activity. Patients are also recommended to take the following medications:

• l-carnitine, ubiquinone to restore metabolic processes in the heart muscle;
• piracetam to remove signs of neurocirculatory dysfunction;
• intravenous B6, B12 and nicotinic acid to improve the condition of the myocardium;
• magnesium and potassium to improve the conduction of nerve impulses and prevent arrhythmia.

The development of atrial fibrillation and tachycardia may serve as indications for prompt hospitalization. But most often these diseases appear when there are several chords or one chord is transverse. Then doctors conduct a detailed analysis of the heart and determine a treatment method for the problem that has arisen. Most often, chords that interfere with blood flow are excised or removed with nitrogen.

If an additional chord is found in a child or adult as a result of a routine examination, but does not cause any discomfort, then medications are not taken. Such patients should normalize their daily routine and avoid overexertion and excessive relaxation. From the strong physical activity will have to give up in favor of walking in the fresh air.

If a child is involved in a certain sport, then you should not sharply prohibit him from attending the section. You should discuss the possibility of classes with a doctor so that he can adequately assess the patient’s condition. There is no need to isolate a child from society, prohibit him from walking and playing with friends, because... this approach will make him feel inferior.

Prevention of complications

Considering that the disease is genetic in nature, it is impossible to prevent its occurrence. If an additional chord is detected in an adult or child, you must follow the specialist’s recommendations in this regard. To avoid complications, in older age you should monitor the amount of cholesterol consumed and your own weight. Excess body weight creates additional stress on blood vessels, causing the heart to work harder.

Classes physical therapy needed for children with an additional chord. They help strengthen the heart muscle, preventing the development of all kinds of pathologies. Most doctors do not advise people with excess chordae to participate in sports at a competitive level. Long swims practical exercises in the flying club, diving can harm people with the presented anomaly. But sprinting, yoga and bodyweight exercises will make your heart muscle stronger.

The left ventricle is the part of the heart that, when contracting, pumps blood into the aorta. This is the main chamber of the heart, providing blood flow throughout the body. Left ventricular hypertrophy is an increase in mass, thickening of its wall. Often, at the same time, expansion of the cavity of the left ventricle occurs - its dilatation. Hypertrophy is both an anatomical and electrocardiographic term.
Anatomical hypertrophy of the left ventricle is manifested on the electrocardiogram (ECG) by a number of signs. A functional diagnostics doctor or cardiologist takes into account the number and severity of such signs. There are several diagnostic criteria, more or less correctly identifying hypertrophy (from 60 to 90% probability). Therefore, not all people with signs of left ventricular hypertrophy on the ECG actually have it. Not all patients with anatomical hypertrophy show it on the ECG. Moreover, the same ECG can be described differently by different doctors if they use different diagnostic criteria in their work.

What diseases does this happen in?

• Left ventricular hypertrophy occurs in young people who are constantly involved in sports. Their heart muscle works intensely during training and naturally increases its mass and volume;
• occurs in diseases associated with difficulty in the exit of blood from the left ventricle into the aorta and with an increase in vascular resistance in the body;
• this ECG sign may be the first symptom of severe heart defects - aortic stenosis and aortic insufficiency. In these diseases, deformation of the valve separating the left ventricle and the aorta occurs. The heart works under a heavy load, but the myocardium copes with it for a long time. A sick person does not feel any discomfort for a long time;
• Left ventricular hypertrophy occurs in a serious disease – hypertrophic cardiomyopathy. This disease is manifested by severe thickening of the walls of the heart. Thickened walls “block” the exit from the left ventricle, and the heart works under load. The disease does not appear immediately; shortness of breath and swelling gradually appear. In advanced cases, this disease may be an indication for heart transplantation.
• This is one of the manifestations of heart damage during arterial hypertension. It can also develop with a moderate but constant increase in pressure. It is precisely to stop the progression of left ventricular hypertrophy that recommendations are aimed at constantly taking medications for hypertension, even with normal pressure.
• may appear in older people with severe atherosclerosis of the heart valves. This narrows the exit hole from the left ventricle into the aorta.

What could this lead to?

If a person has signs of left ventricular hypertrophy on an ECG, but it is not confirmed by echocardiography ( ultrasound examination heart) – there is no reason to worry. This ECG feature is probably due to increased body weight or a hypersthenic constitution. The ECG phenomenon of left ventricular hypertrophy itself is not dangerous.

If hypertrophy on the ECG is accompanied by a real increase muscle mass, in the future this can cause heart failure (shortness of breath, swelling) and severe heart rhythm disturbances ( ventricular extrasystole, ventricular tachycardia). Athletes should not forget about this when creating a training regimen.

What to do and how to treat

If a person's ECG shows left ventricular hypertrophy, he needs to undergo an ultrasound examination of the heart, or echocardiography (EchoCG). This method will help to accurately determine the cause of the increase in myocardial mass, as well as evaluate heart failure.
If it is not possible to conduct echocardiography, it is recommended to perform radiography of the heart in two projections, sometimes with contrasting of the esophagus.
To exclude heart rhythm disturbances, it is recommended to undergo daily ECG monitoring. To diagnose hypertension during the day, it is necessary to undergo 24-hour blood pressure monitoring.

Left ventricular hypertrophy is irreversible. However, treating the underlying condition helps prevent the condition from progressing. For example, angiotensin-converting enzyme inhibitors (enalapril, captopril and many others) widely used in the treatment of hypertension not only stop the development of hypertrophy, but also cause some regression.

Thus, when detected on ECG signs left ventricular hypertrophy, you should contact a physician or cardiologist for further examination.

You can use our ECG interpretation service →

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Why does a left ventricular aneurysm develop and how to treat it?

Aneurysm of the left ventricle of the heart is a pathology that develops after a myocardial infarction. Typically, the location of the disease is the area in the front or upper part of the heart. This happens due to the thinning of muscle tissue, it no longer has the ability to contract, which means that the process of their protrusion begins under high pressure blood flow Given pathological condition is a very serious consequence of a heart attack. As a result, the functioning of the hematopoietic system is disrupted. All this leads to the patient requiring surgical intervention by specialized specialists.

Reasons for development

When starting to talk about an aneurysm developing in the left ventricle, experts identify several causes.

The main one among them is the rapid wear and tear of muscle tissue of the “heart” organ, others include the following:

• disruption of the functioning of all wall tissue layers, the apex of the left ventricle at the time of a heart attack;
• the fact of increased pressure in the area located inside the ventricle;
• neglecting the recommendations of specialists on the organization of physical activity in a heart attack state, that is, exceeding it;
• failures in the process of regeneration of muscle tissue in the post-infarction state, as a result of which a scar appears;
• mechanical injuries;
• a severe form of one or another illness that has developed in the body due to infection;
• receiving a mechanical injury to the heart with a knife or other sharp, piercing, cutting objects;
• receiving a closed injury (usually occurs after a fall from a great height, a car accident);
• rheumatism;
• bacterial endocarditis;
• syphilis infection.

Forms of the disease and symptomatic manifestations

The main forms of the disease are determined by the period of its occurrence.

These include:

• acute - formed during the first two weeks after a heart attack;
• subacute - formed during the first month after a heart attack and is characterized by the formation of a scar with an irregular shape;
• chronic is a rather difficult form to diagnose; it is periodically confused with heart failure, which is acute in nature.

And there is also a division of aneurysm into types according to the form of its manifestations.

This division includes:

1. Mushroom-shaped.
2. Saccular.
3. Diffuse, in other words - flat.
4. Delaminating.

Only a timely examination can give a clear idea of ​​what kind of aneurysm the specialists had to deal with. In such cases, we can talk about prescribing adequate treatment, which the patient must follow strictly.

People who have experienced a left ventricular aneurysm know that this pathological condition is characterized by certain symptomatic manifestations.

These include:

• cardiac arrhythmia;
• painful sensations in the area located behind the sternum;
• shortness of breath, turning into severe attacks of suffocation (usually manifests itself at the time of increased physical exertion);
• the appearance of swelling of organ tissues;
• the occurrence of noise sounds arising in the upper part of the cardiac organ.

If these symptoms occur some time after discharge from the hospital, when the rehabilitation process after a heart attack ends, you should immediately consult a doctor. Otherwise, there may be a threat to the patient’s life, which does not manifest itself if contacted early stages development of a pathological condition.

Diagnosis of the disease and therapeutic measures

Timely diagnostic procedures are the only the right way prescribing adequate treatment in the event of an aneurysm. After diagnosis, the severity of the disease is determined, as well as the duration of treatment courses. When a muscle bulges, it is extremely important at the time of diagnostic examination to find out three aspects concerning it.

These include:

• location;
• size;
• kind of structural type.

Other research methods necessary for an aneurysm include:

1. Carrying out laboratory research genetic and urinary material, which makes it possible to identify concomitant diseases that may influence the course of development of the disease.
2. Taking an X-ray of the chest area, which allows you to exclude or detect chest swelling in time.
3. Ventriculography of a radioisotope nature, which gives full information not only about the location of the pathology, but also determines the residual contractility of cardiac tissue.
4. Magnetic resonance imaging, which is used in cases where surgical intervention is necessary, because only this procedure allows one to determine how dilated the arterial vascular passages are, as well as their exact location, size and location of the disease.
5. Ultrasound (ultrasound examination), which allows the specialist to clarify information about the bulging zones and places of thinning of the heart muscles.

Considering the fact that the pathological condition is accompanied by a cessation of the normal performance of the contraction function of the heart muscles, it can lead to heart failure acute type failure to follow doctor's recommendations. This can cause rupture of the muscle walls, which - in turn - will cause the patient's immediate death.

• compliance with strict bed rest for a certain period;
• refusal of any physical activity;
• use medicines, helping to reduce blood pressure;
• use medical supplies, preventing the development of blood clots;
• application medications antiarrhythmic action.

However, such therapy does not fully help the patient.

Usually the pathology is eliminated by surgical intervention using modern equipment. If experts offer just such a method of treatment, you should agree, remembering that an aneurysm leads to ruptures of heart tissue, which causes instant death.

Basic preventative measure To prevent the development of the disease, it is necessary to maintain a lifestyle that will not cause the development of a heart attack. This involves maintaining healthy image life: be sure to adhere to a balanced diet and moderate physical activity.

The diagnosis of left ventricular diastolic dysfunction is most often made in elderly patients. Their heart wears out and begins to perform its functions poorly. The essence of this disease is that during the period of relaxation the left ventricle of the myocardium is not filled enough.

The pathological process occurring in the heart must be treated promptly, because the disease can lead to the development of complications. The most dangerous consequence- heart failure.

Reasons for the development of deviation

Normally healthy person the heart fills with blood in three stages. First, the heart muscle relaxes, blood flows from the atrium into the ventricle, the atrium contracts, and the ventricle fills. If failures occur at any one stage, diastolic dysfunction develops.

As a result of insufficient filling of the ventricle with blood, improper ejection occurs and the supply is disrupted. internal organs and myocardial function.

With diastolic dysfunction, the walls of the ventricle lose their elasticity, and the heart muscle loses the ability to completely relax.

The main reason for the development of the pathological process is myocardial hypertrophy, the development of which is facilitated by the following factors:

• aortic stenosis;
• hypertension;
• hypertrophic cardiomyopathy.

Hemodynamic parameters may be impaired due to diseases such as:

• pericarditis - a condition when the ventricles and atria are compressed as a result of thickening of the pericardium;
• amyloidosis - atrophy of muscle tissue caused by the accumulation of deposits;
• diseases of the coronary vessels, which lead to a decrease in the elasticity of the myocardium and the development of coronary artery disease.

Type 1 left ventricular diastolic dysfunction develops most often in patients who suffer from the problem excess weight or have been diagnosed with diabetes.

Timely diagnosis and initiation of treatment will help prevent the development of complications and improve the patient’s condition.

Clinical picture of the disease

Very often, diastolic dysfunction occurs without any symptoms. Basically, 45% of patients go to the hospital when the pathological process intensively progresses.

Absence clinical signs- this is the insidiousness and danger of this disease.

A person may not even suspect that he is developing this disease until it becomes advanced. Signs appear when blood stagnates in the pulmonary arteries.

Diastolic dysfunction is accompanied by the following symptoms:

• slight shortness of breath, which manifests itself first with increased load, then at rest;
• dry cough;
• failure heart rate, painful sensations in the chest;
• increased fatigue, which intensifies when performing physical work.

In order to diagnose the disease in time, you should regularly visit a cardiologist, get tested, and monitor your health.

Classification of pathology

The development of diastolic dysfunction occurs gradually. Signs appear one by one.

Depending on the degree of development and neglect of the disease, it is divided into several types:

1. Type 1 diastolic dysfunction of the left ventricle - relaxation is impaired, the process of relaxation of the ventricle is slowed down.
2. Type 2 diastolic dysfunction - there is an increase in pressure in the atrium, the left ventricle is filled due to the pressure difference.
3. Type 3 diastolic dysfunction - the elasticity of the tissues of the left ventricle decreases, they become rigid.

Early diagnosis will help avoid complications and prevent the progression of the disease. If the pathological process is started, irreversible changes begin to occur in the heart. Then it is very difficult to save a person, because concomitant diseases develop.

Diagnosis of dysfunction

After detecting primary signs of pathology, you should immediately consult a doctor. Cardiologists provide treatment.

The specialist will conduct a consultation and prescribe a number of additional diagnostic techniques:

1. Laboratory methods. Must pass general analysis blood, blood test for biochemical indicators, hormones, hemoglobin levels and some microelements.
2. An ECG is an informative method with which you can determine the condition of the heart muscle, diagnose hypertrophy, arterial hypertension or coronary artery disease.
3. Echocardiography - using this technique, you can determine the ejection fraction, the size of the ventricles, and diagnose defects and cardiomyopathy.
4. X-ray allows you to see changes in the structure of the myocardium and determine hypertrophy.
5. MRI is prescribed as an auxiliary method when it is difficult to confirm or refute the diagnosis.

These diagnostic techniques allow not only to diagnose the patient with diastolic dysfunction, but also to determine the causes of the disease, the condition of the heart, and also prescribe the correct treatment.

Treatment of the disease

If the disease is diagnosed even at the asymptomatic stage, treatment still needs to be prescribed.

This will help prevent complications and improve the patient’s condition.

When the symptoms of diastolic dysfunction are pronounced, the patient is prescribed drugs from different pharmacokinetic groups:

1. Diuretics stimulate the removal of excess fluid from the body, the removal of edema, and the elimination of stagnant processes in the internal organs.
2. Beta blockers. As a result of taking these drugs, the load on the heart is reduced and its contractions are normalized.
3. ACE inhibitors, sartans increase myocardial elasticity and help lower blood pressure.
4. Calcium antagonists have a positive effect on the myocardium, promoting its relaxation.

There are drug and non-drug treatments for diastolic dysfunction. The second category includes lifestyle changes and diet therapy.

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 reasons for this phenomenon are mostly based on a decrease in the compliance of the walls. Signs of left ventricular diastolic dysfunction are manifested in an increase in the ratio of end pressure to end volume.

Filling stages

The stages of diastolic filling in the left ventricle include relaxation, passive filling, and filling due to atrial contraction. Relaxation represents calcium ions from actin-myosin filaments. Because of ischemia, the excretion of ions is inhibited, as a result of which relaxation becomes insufficient. With a decrease in filling, arterial and venous hypertension, nocturnal paroxysmal dyspnea, cough, and shortness of breath are noted. Relaxation is followed by passive filling. The determinant of blood volume is considered to be the compliance of the ventricular walls, a decrease in which reduces passive filling. Active contraction of the atrium walls causes the entry of 15-20% of the diastolic end volume. The rigidity of the walls provokes an increase in the incoming volume. With ischemia and pathological stiffness, it significantly increases the risk of cardiogenic edema in the lungs.

Left ventricular diastolic dysfunction. Reasons

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

Left ventricular diastolic dysfunction. Treatment

Experts note that theoretically, the improvement should be influenced by drugs that reduce LV hypertrophy, increase active relaxation and improve its compliance. Left ventricular diastolic dysfunction is also corrected by angiotensin-converting enzyme inhibitors. Data on beneficial effects were obtained in the majority of patients.

It is noted very positive influence such, for example, as “Enalapril”. Diastolic dysfunction can be treated in a fairly short time. So, usually after eight to sixteen weeks there is already an improvement. These results are observed even before the onset of statistically significant regression of hypertrophy in the LV. The effect on improvement has practical significance in the process of choosing therapy in patients with arterial hypertension and insufficiency of cardiac activity in a chronic course. Experts note effectiveness in the early stages, including asymptomatic disorders, as well as in the later stages of decompensation. During treatment, any drug of this group can be prescribed, but preference is given to drugs whose effectiveness has been tested experimentally. Thus, there was a significant improvement in diastolic function when patients received therapy with the drug “Lisinopril”.