Clinical Diagnosis and Management of Left Ventricular Diastolic Dysfunction

  • William H. Gaasch
  • Gerald Izzi


Diastolic dysfunction is a relatively common problem that may be mild and asymptomatic or it may present with severe disabling symptoms. It is most frequently due to coronary artery disease and/or left ventricular (LV) hypertrophy, and it is especially common in the older populations. Patients with diastolic dysfunction and normal-systolic function are best treated with calcium-channel blocking agents or beta-blocking agents (drugs that are generally avoided in patients with significant systolic dysfunction). These drugs are used in the same dosage as used in patients with angina or hypertension. Most treatment is empirical or based on symptomatic relief and, therefore, periods of cautious trial and error are the rule. When diastolic dysfunction is associated with systolic dysfunction, it may be necessary to treat both conditions, but in general, positive inotropic agents and arterial vasodilators are not useful in patients with diastolic dysfunction.


Diastolic Dysfunction Left Ventricular Filling Mitral Valve Disease Peak Filling Rate Ventricular Diastolic Dysfunction 
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  1. 1.
    Gaasch WH, Levine HJ, Quinones MA, Alexander JK (1976) Left ventricular compliance: Mechanisms and clinical implications. Am J Cardiol 38: 645–653PubMedCrossRefGoogle Scholar
  2. 2.
    Grossman W, McLaurin LP (1976) Diastolic properties of the left ventricle. Ann Intern Med 84: 316–326PubMedGoogle Scholar
  3. 3.
    Mirsky I (1976) Assessment of passive elastic stiffness of cardiac muscle: Mathematical concepts, physiologic and clinical considerations, directions of future research. Prog Cardiovasc Dis 18: 277–308PubMedCrossRefGoogle Scholar
  4. 4.
    Glantz SA, Parmley WW (1978) Factors which affect the diastolic pressure-volume curve. Circ Res 42: 171–180PubMedGoogle Scholar
  5. 5.
    Brutsaert DL, Housmans PR, Goethals MA (1980) Dual control of relaxation: Its role in the ventricular function in the mammalian heart. Circ Res 47: 637–652PubMedGoogle Scholar
  6. 6.
    Mirsky I (1984) Assessment of diastolic function: suggested methods and future considerations. Circulation 69: 836–841PubMedCrossRefGoogle Scholar
  7. 7.
    Gaasch WH, Apstein CS, Levine HJ (1986) Diastolic properties of the left ventricle. In: Levine HJ, Gaasch WH (eds) The ventricle. Martinus Nijhoff, Boston, 143–170Google Scholar
  8. 8.
    Grossman W, Lorell BH (1988) Diastolic relaxation of the heart. Martinus Nijhoff, BostonGoogle Scholar
  9. 9.
    Harizi RC, Bianco JA, Alpert JS (1988) Diastolic function of the heart in clinical cardiology. Arch Intern Med 148: 99–109PubMedCrossRefGoogle Scholar
  10. 10.
    Katz AM (1988) Influence of altered inotropy and lusitropy on ventricular pressure-volume loops. J Am Coll Cardiol 11: 438–445PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 1989

Authors and Affiliations

  • William H. Gaasch
    • 1
  • Gerald Izzi
    • 2
  1. 1.Department of Medicine (Cardiology)The Med Center/MemorialWorcesterUSA
  2. 2.The Medical Center of BostonBostonUSA

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