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[Left ventricular diastolic function: physiology, physiopathology, evaluation, therapy, consequences of anesthesia]
J P Gékière1, P Valat, P Gosse
1Service d'anesthésie-réanimation-algologie, institut Bergonié, Bordeaux, France.
Annales Francaises D'Anesthesie Et De Reanimation
|September 29, 1998
Summary
Left ventricular diastolic dysfunction is common in the elderly, causing heart failure. While Doppler echocardiography aids assessment, treatment for diastolic anomalies remains challenging.
Area of Science:
- Cardiology
- Geriatrics
Context:
- Left ventricular diastolic dysfunction is a significant cause of congestive heart failure, particularly in the elderly.
- It accounts for 30-40% of heart failure cases, with lower mortality than systolic dysfunction.
Purpose:
- To review the mechanisms and assessment of left ventricular diastolic dysfunction.
- To discuss the impact of anesthesia and current therapeutic approaches.
Summary:
- Diastolic dysfunction involves relaxation anomalies, proto-mesodiastolic filling, and compliance issues, impacting the pressure-volume relationship.
- Invasive methods are standard, but Doppler echocardiography is crucial for assessing diastolic function.
- Relaxation anomalies appear early in cardiopathies, while compliance issues indicate advanced disease.
Impact:
- Anesthetic agents can negatively affect ventricular diastole, exacerbating fragile conditions.
- Long-term therapy focuses on managing left ventricular hypertrophy.
- Emergency treatment strategies for diastolic anomalies are not yet standardized.