Diastolic dysfunction - What an anesthesiologist needs to know?

Diastolic dysfunction (DD) is a common condition that is increasingly encountered in patients undergoing both cardiac and noncardiac surgery as the age profile of our patient population increases and the noninvasive diagnosis of DD becomes more accessible. There is a growing body of evidence demonstrating the significance of DD and adverse perioperative outcomes, and thus, it is becoming imperative for anesthesiologists to have an understanding of the pathophysiology, diagnosis, and management of patients with DD. Current guidelines are based on transthoracic echocardiogram (TTE) measurements in patients who are spontaneously breathing and in a euvolemic state and, consequently, not applicable to the perioperative period. In this review article, we discuss the grading of DD as well as introduce a practical approach to the diagnosis and management of patients with DD during the perioperative period.