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[Hemodynamics in heart failure: systolic and diastolic dysfunction]
1Departement für Innere Medizin, Kardiologie, Universitätspital Zürich.
Insights
Cardiac insufficiency involves reduced cardiac output and elevated filling pressures. It stems from systolic dysfunction (reduced ejection fraction) or diastolic dysfunction (decreased ventricular compliance).
Area of Science:
- Cardiology
- Physiology
- Pathophysiology
Abstract:
Cardiac insufficiency is hemodynamically characterised by reduced cardiac output and increased diastolic filling pressure at rest and/or during physical activity. The increase in diastolic filling pressure compensates cardiac output and is either a result of increased initial tension of muscle fibers (Frank-Starling's Law) or a sign of decreased myocardial compliance. Increased initial tension of muscle fibers is a sign of systolic insufficiency, whereas reduced ventricular compliance indicates a disorder of diastolic ventricular function. In systolic insufficiency (= systolic dysfunction) a decrease in the ventricular ejection fraction is important, as is an increase in filling pressure. In diastolic congestive heart failure (= diastolic dysfunction) a reduced ventricular compliance with normal stroke function is typical.