Diastolic dysfunction, diagnostic and perioperative management in cardiac surgery

Area of Science:

• Cardiology
• Anesthesiology
• Perioperative Medicine

Background:

• Left ventricular diastolic dysfunction is often underestimated.
• It is linked to adverse outcomes in patients undergoing various surgical procedures.
• Diastolic dysfunction increases the risk of perioperative acute decompensation.

Purpose of the Study:

• To review recent findings on the role of diastolic dysfunction in the perioperative period.
• To discuss recent advances in the diagnosis and management of diastolic function.
• To highlight the importance of physician awareness and knowledge regarding diastolic dysfunction.

Main Methods:

• This review synthesizes current literature on diastolic dysfunction.
• It focuses on diagnostic advancements and perioperative management strategies.
• The review examines the implications of diastolic dysfunction grading systems.

Main Results:

• Recent diagnostic advancements have limited intraoperative applicability.
• Perioperative management strategies are primarily preventive and symptomatic due to a lack of disease-specific therapies.
• Diastolic dysfunction is associated with poorer outcomes in both cardiac and noncardiac surgery patients.

Conclusions:

• Perioperative physicians must be aware of diastolic dysfunction and its implications.
• Knowledge of diastolic dysfunction grading systems is essential for appropriate patient care.
• Understanding the pathophysiologic changes associated with diastolic dysfunction is critical for optimizing perioperative management.