Heart failure with preserved systolic function of the left ventricle
Authors:
V. Melenovský
Authors‘ workplace:
Klinika kardiologie
; Přednosta: prof. MUDr. Josef Kautzner, DrSc.
; Institut klinické a experimentální medicíny, Praha
Published in:
Prakt. Lék. 2010; 90(4): 235-238
Category:
Of different specialties
Overview
It has been increasingly recognized that almost half of patients hospitalized for heart failure have relatively preserved systolic function of the left ventricle. The prevalence of this type of heart failure is increasing and the long-term prognosis is similarly unfavourable as in systolic dysfunction. In its typical form, this disease occurs in older patients, more often in females, with a long history of arterial hypertension and/or diabetes, who have concentric left ventricular hypertrophy or remodelling, dilated left atrium and abnormalities of diastolic ventricular filling. Despite being a relatively common disease, its pathophysiology has not yet been completely elucidated. Besides abnormal diastolic ventricular properties and decreased contractile reserve, other extraventricular mechanisms are equally relevant - such as increased stiffness of large arteries, abnormal mechanical function of the left atrium and abnormal autonomic cardiovascular control.
Long-term care consists of managing fluid retention with diuretics and meticulous control of hypertension, preferably with drugs with proven capacity to regress left ventricular hypertrophy. It can be expected that the current intensive research on this condition will identify critical mechanisms responsible for the pathophysiology, which will ultimately lead to more specific and causal therapies.
Key words:
heart failure, ejection fraction, diastolic dysfunction, arterial hypertension, left ventricular hypertrophy.
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