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[Assessment and evaluation of cardiac function]
1Faculty of Medicine, University of Tokyo.
Insights
Cardiac function assessment is crucial for patients with heart disorders. Ventricular dysfunction, encompassing both systolic and diastolic components, impacts heart failure management and requires understanding its contributing factors.
Area of Science:
- Cardiology and cardiovascular physiology.
- Diagnostic imaging and hemodynamic assessment.
Context:
- Cardiac function evaluation is standard for acute and chronic heart conditions.
- Therapies aim to enhance ventricular performance.
- Quantitative measurement techniques for ventricular size, shape, and motion are available.
Purpose:
- To define and differentiate systolic and diastolic ventricular dysfunction.
- To explain hemodynamic descriptions using pressure-volume diagrams.
- To discuss factors influencing ventricular dysfunction in heart failure.
Summary:
- Ventricular dysfunction has two components: systolic and diastolic.
- Systolic dysfunction depresses the end-systolic pressure-volume relation.
- Diastolic dysfunction distorts the diastolic relation, increasing diastolic pressure.
Impact:
- Understanding dysfunction aids in targeted heart failure therapy.
- Differentiating dysfunction types informs treatment strategies.
- Identifying influencing factors improves patient management.
Abstract:
Assessment and evaluation of cardiac function have become commonplace in the care of cardiac patients with acute or chronic disorders, since therapy of most cardiac diseases is designed specifically to improve ventricular function. Now, various techniques are available for quantitative measurements of the size, shape and motion of the ventricle. Ventricular dysfunction is defined with two components, systolic and diastolic dysfunction, and can be described hemodynamically in terms of the ventricular pressure-volume diagram. Pure systolic dysfunction is associated with a depression in the end-systolic pressure-volume relation, using the Frank-Starling relation to restore cardiac output toward normal. In contrast, pure diastolic dysfunction is associated with preservation of the end-systolic pressure-volume relation but distortion of the diastolic relation, showing higher diastolic pressure at any given volume. However, in patients presenting clinically with heart failure, both systolic and diastolic dysfunction are usually observed. In this context, factors and disorders that influence ventricular dysfunction are described, considering extrinsic or intrinsic to the ventricular chambers.