Diastolic dysfunction in hypertension: a comprehensive review of pathophysiology, diagnosis, and treatment
Camilla Ikast Ottosen1, Wilson Nadruz2, Riccardo M Inciardi3
1Department of Cardiology, Center for Translational Cardiology and Pragmatic Randomized Trials (CTCPR), Herlev & Gentofte Hospital, University of Copenhagen, Gentofte Hospitalsvej 8, 2900 Hellerup, Denmark.
Insights
Left ventricular diastolic dysfunction (LVDD) in hypertension impairs heart filling and precedes heart failure. Management is challenging due to complex causes and lack of specific treatments.
Area of Science:
- Cardiology
- Hypertension Research
- Cardiac Physiology
Background:
- Diastolic dysfunction involves impaired ventricular relaxation or filling.
- Left ventricular diastolic dysfunction (LVDD) is prevalent in hypertension, increasing morbidity and mortality.
- LVDD is a key precursor to heart failure with preserved ejection fraction.
Purpose of the Study:
- To review the pathophysiology of LVDD in hypertension.
- To outline diagnostic methods and clinical manifestations of LVDD.
- To discuss management strategies and future research directions for LVDD.
Main Methods:
- Review of existing literature on LVDD in hypertension.
- Analysis of pathophysiological mechanisms.
- Synthesis of diagnostic and management approaches.
Main Results:
- LVDD pathophysiology involves cardiac structural/functional changes, neurohormonal activation, and vascular stiffness.
- Echocardiography is the primary diagnostic tool for LVDD.
- Effective management strategies for LVDD are still evolving.
Conclusions:
- LVDD in hypertension is a complex condition with significant clinical implications.
- Current management of LVDD is challenging, highlighting the need for targeted therapies.
- Further research is crucial for advancing LVDD treatment and improving patient outcomes.
Abstract:
Diastolic dysfunction refers to impaired relaxation or filling of the ventricles during the diastolic phase of the cardiac cycle. Left ventricular diastolic dysfunction (LVDD) is common in hypertensive individuals and is associated with increased morbidity and mortality. LVDD serves as a critical precursor to heart failure, particularly heart failure with preserved ejection fraction. The pathophysiology of LVDD in hypertension is complex, involving alterations in cardiac structure and function, neurohormonal activation, and vascular stiffness. While the diagnosis of LVDD relies primarily on echocardiography, management remains challenging due to a lack of specific treatment guidelines for LVDD. This review offers an overview of the pathophysiological mechanisms underlying LVDD in hypertension, diagnostic methods, clinical manifestations, strategies for managing LVDD, and prospects for future research.
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