Diastolic dysfunction of the left ventricle type 1 disability

Ventricular dysfunction is more often an age-related disorder and occurs mainly in older people. Women are especially susceptible to this pathology.

Diastolic dysfunction of the left ventricle causes hemodynamic disturbances and atrophic changes in the structure of the myocardium. The period of diastole is characterized by muscle relaxation and the filling of the ventricle with arterial blood.

The process of filling the heart chamber consists of several stages:

  • relaxation of the heart muscle;
  • under the influence of the pressure difference from the atrium, the blood passively flows into the ventricle;
  • with atrial contraction, the remaining blood is abruptly expelled into the ventricle.

In case of violation of one of the stages, insufficient blood flow is observed, which contributes to the development of left ventricular failure.

Diastolic ventricular dysfunction can be caused by certain diseases that can significantly disrupt the hemodynamics of the heart:

  • Diastolic dysfunction of the left ventricle is a consequence of thickening of the heart muscle tissue (myocardial hypertrophy). As a rule, hypertrophy develops in people with hypertension, aortic stenosis and hypertrophic cardiomyopathy.
  • It can develop under the influence of pericarditis, due to which the thickened walls of the pericardium compress the chambers of the heart.
  • With pathological changes in the coronary vessels that cause coronary heart disease due to coarsening of the heart tissue and the appearance of scars.
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Especially often, the disease develops in people with diabetes or obesity. In this case, the pressure on the heart chambers increases, the organ cannot fully function and ventricular dysfunction develops.

Diastolic dysfunction of the left ventricle over time may practically not bother the patient. However, this pathology is accompanied by certain symptoms:

  • cardiopalmus;
  • cough, manifested more often in a horizontal position;
  • fatigue with habitual physical exertion;
  • shortness of breath at first accompanies only during physical exertion, then sharply arises even at rest;
  • heart rhythm disturbances, manifested by atrial fibrillation;
  • difficulty breathing (dyspnea) at night. 73b01e804bfae8141c17316a4956c48c - Diastolic dysfunction of the left ventricle type 1 disability

If such symptoms are found, it is necessary to seek medical help and undergo an examination to identify the cause of the discomfort and eliminate the disease at the initial stage.

Since the disease gradually worsens the hemodynamics of the heart, several stages are distinguished:

  • Stage 1 is characterized by minor hemodynamic disturbances. Diastolic dysfunction of the left ventricle of type 1 causes a slowed down process of the transition of chambers from systole to diastole, the main volume of blood enters the ventricle during relaxation of its chambers.
  • 2nd stage – the filling of the ventricle is carried out due to the pressure difference, since at this stage the pressure rises reflexively in the left atrium.
  • Stage 3 – the pressure in the left atrium remains high, while the left ventricle becomes stiff, losing the elasticity of the fibers. fa082ff9a9ce10af651b7f732dd3d1d5 - Diastolic dysfunction of the left ventricle type 1 disability

Diastolic dysfunction of the left ventricle type 1 is treatable, while subsequent stages of the disease cause irreversible changes in the work and physiological state of the organ. That is why it is necessary to consult a doctor at the first manifestation of the symptoms of the disease.

To identify physiological changes and disorders of the hemodynamics of the heart, it is necessary to conduct a full examination, which includes several diagnostics:

  • Echocardiography with additional dopplerography is the most accessible and informative method for examining the cardiovascular system. Using it, you can quickly />

Using the above methods, the types of diastolic dysfunction of the left ventricle are also determined.

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Treatment of the disease

To eliminate violations of the hemodynamic process and prevent the development of irreversible changes, it is necessary to prescribe drugs that help maintain optimal heart performance (blood pressure, heart rate). Normalization of water-salt metabolism will reduce the load on the heart. The elimination of left ventricular hypertrophy is also required.

After the examination, the attending physician will select a suitable complex of drugs that can maintain normal all indicators. Heart failure also plays an important role, the treatment of which requires compliance with a large number of medical recommendations.

Diastolic dysfunction of the left ventricle, the treatment of which requires high professionalism of the doctor and strict adherence to all his prescriptions, is rare in young active people. That is why, with age, it is important to maintain activity and periodically take vitamin complexes that help to saturate the body with the necessary trace elements.

Diastolic myocardial dysfunction of the left ventricle, which is detected in time, will not do much harm to human health and will not cause serious atrophic changes in the heart tissue.

Ventricular dysfunction is more often an age-related disorder and occurs mainly in older people. Women are especially susceptible to this pathology. Diastolic dysfunction of the left ventricle causes hemodynamic disturbances and atrophic changes in the structure of the myocardium. The period of diastole is characterized by muscle relaxation and the filling of the ventricle with arterial blood. The process of filling the heart chamber consists of several stages:

  • relaxation of the heart muscle;
  • under the influence of the pressure difference from the atrium, the blood passively flows into the ventricle;
  • with atrial contraction, the remaining blood is abruptly expelled into the ventricle.

Ventricular myocardial dysfunction: causes, symptoms, treatment

Factors leading to the development of diastolic dysfunction worsen the relaxation process, reduce the elasticity of the walls of the left ventricle, mainly due to the development of myocardial hypertrophy (thickening).

The following diseases lead to myocardial hypertrophy:

  • hypertrophic cardiomyopathy;
  • hypertonic disease;
  • aortic stenosis (narrowing of the mouth of the aorta).

In addition, diseases such as can cause hemodynamic disturbances:

  • constrictive pericarditis – is a thickening of the pericardium, as a result of which there is a compression of the heart chambers;
  • primary amyloidosis – deposition of amyloid causes atrophy of muscle fibers and a decrease in myocardial elasticity;
  • pathology of the coronary vessels, leading to the development of chronic coronary heart disease and the development of rigidity (stiffness) of the myocardium due to cicatricial changes.

In connection with the development of compensatory pulmonary hypertension, the preload on the right heart is increased, diastolic dysfunction of both ventricles is formed.

Sazykina Oksana Yuryevna, cardiologist

In order for each cell of the human body to receive blood with vital oxygen, the heart must work correctly. The pumping function of the heart is carried out with the help of alternate relaxation and contraction of the heart muscle – myocardium.

If any of these processes are disturbed, dysfunction of the ventricles of the heart develops, and the ability of the heart to push blood into the aorta gradually decreases, which affects the blood supply to vital organs.

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Developed dysfunction, or myocardial dysfunction.

Ventricular dysfunction is a violation of the ability of the heart muscle to contract with the systolic type to expel blood into the vessels, and relax with diastolic to take blood from the atria. In any case, these processes cause a violation of normal intracardiac hemodynamics (movement of blood through the heart chambers) and stagnation of blood in the lungs and other organs.

Both types of dysfunction are associated with chronic heart failure – the more ventricular function is impaired, the higher the severity of heart failure.

If heart failure can be without heart dysfunction, then dysfunction, on the contrary, does not occur without heart failure, that is, in every patient with ventricular dysfunction, there is chronic heart failure of the initial or severe stage, depending on the symptoms. This is important for the patient to consider if he considers medication to be optional.

You also need to understand that if a patient is diagnosed with myocardial dysfunction, this is the first signal that some processes are going on in the heart that need to be identified and treated.

calendar_today April 27, 2016

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Diastolic dysfunction is a relatively new diagnosis. Until recently, even cardiologists rarely exhibited it. However, diastolic dysfunction is currently one of the most commonly detected heart problems with echocardiography.

Recently, cardiologists and therapists are increasingly setting their patients a “new” diagnosis – diastolic dysfunction. In severe cases of the disease, diastolic heart failure (HF) can occur.

Currently, diastolic dysfunction is detected quite often, especially in older women, most of whom are surprised to learn that they have heart problems.

Often, patients diagnosed with diastolic dysfunction may develop diastolic heart failure.

Neither diastolic dysfunction, nor diastolic heart failure are actually “new” diseases – they have always affected the human cardiovascular system. But only in the last decades, these two diseases began to be detected frequently. This is due to the widespread use of ultrasound methods (echocardiography) in the diagnosis of heart problems.

It is believed that almost half of patients admitted to the emergency department with acute heart failure actually have diastolic heart failure.

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But to establish the correct diagnosis can be difficult, because after stabilizing the condition of such a patient, the heart may look completely normal during echocardiography, if the specialist purposefully does not look for signs of diastolic dysfunction. Therefore, inattentive and unguarded doctors often miss this disease.

The heart cycle is divided into two phases – systole and diastole. During the first ventricle (the main chambers of the heart), they contract, throwing blood from the heart into the arteries, and then relax. During relaxation, they are re-filled with blood to prepare for the next contraction. This phase of relaxation is called diastole.

The heart cycle consists of systole (contraction of the heart) and diastole (relaxation of the myocardium), during which the heart fills with blood

However, sometimes, due to various diseases, the ventricles become relatively “stiff.” In this case, they cannot completely relax during diastole. As a result, the ventricles are not completely filled with blood, but it stagnates in other parts of the body (in the lungs).

The pathological tightening of the walls of the ventricles and the resulting insufficient blood filling during diastole is called diastolic dysfunction. When diastolic dysfunction is so pronounced that it causes congestion in the lungs (that is, the accumulation of blood in them), it is considered that this is already diastolic heart failure.

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Diastole dysfunction may be asymptomatic for a long time before it begins to manifest clinically. The following symptoms are characteristic of such patients:

  • shortness of breath that occurs during physical exertion, then at rest;
  • cough worse in horizontal position;
  • reduced exercise tolerance, fast fatigue;
  • palpitations
  • paroxysmal night dyspnea;
  • rhythm disturbances are often present (atrial fibrillation).

How is diastolic dysfunction of the left ventricle manifested?

The human heart is represented by four chambers, whose work does not stop even for a minute. For relaxation, the body uses the spaces between contractions – diastoles. At these moments, the heart departments relax as much as possible, preparing for a new compression.

In order for the body to be fully supplied with blood, a clear, coordinated activity of the ventricles and atria is necessary. If the relaxation phase is disturbed, the quality of the cardiac output worsens, and the heart wears out rather without sufficient rest.

One of the common pathologies associated with impaired relaxation function is called “diastolic dysfunction of the left ventricle” (LAD).

Thus, a huge load falls on the left ventricle. If the dysfunction of this chamber develops, then all organs and systems will suffer from a lack of oxygen and nutrients. Diastolic left ventricular pathology is associated with the inability of this department to fully absorb blood: the cardiac cavity is either not completely filled, or this process is very slow.

Development mechanism

Diastolic dysfunction of the left ventricle develops when at least one of the successive stages of enrichment of the heart chamber with blood during diastole is disrupted.

  1. Myocardial tissue enters the relaxation phase.
  2. There is a passive flow of blood from the atrium to the cavity of the ventricle due to the pressure drop in the chambers.
  3. The atrium makes a contractile movement, freeing itself from the rest of the blood, pushing it into the left ventricle.

In its development, left ventricular diastole dysfunction goes through several stages. Each of them has its own distinctive features and is characterized by a different degree of danger.

This is the initial stage of the pathology. Diastolic dysfunction of the left ventricular chamber according to the 1st type corresponds to a slightly delayed relaxation phase.

Most of the blood enters the cavity during relaxation while contracting the left atrium. A person does not feel the manifestation of violations, obvious signs can be detected only by echocardiography.

This stage is also called hypertrophic, as it occurs against the background of myocardial hypertrophy.

  • Pseudonormal stage of moderate severity (type 2).

The ability of the left ventricle to relax is further impaired. This affects the cardiac output. To compensate for the lack of blood flow, the left atrium works in an enhanced mode.

This phenomenon is accompanied by increased pressure in this cavity and an increase in the size of the muscle wall. Now the saturation of the left ventricle with blood is provided by the pressure difference inside the chambers.

A person feels symptoms that indicate pulmonary congestion and heart failure.

  • The stage is restrictive, with a severe degree of disturbances (type 3).

The pressure in the atrium, located on the left, increases significantly, the walls of the left ventricle become denser, lose their flexibility. Violations are accompanied by severe symptoms of a life-threatening condition (congestive heart failure). Possible pulmonary edema, an attack of cardiac asthma.

It should distinguish between the concepts of “diastolic dysfunction of the left ventricle” and “left ventricular failure”.

In the first case, there is no obvious threat to the patient’s life if the pathology is at the first stage.

The aggravation of the condition can be avoided with adequate treatment of diastolic dysfunction of the cavity of the left ventricle of the 1st type. The heart continues to work almost unchanged, systolic function is not impaired.

BOTTOM Line - Diastolic dysfunction of the left ventricle type 1 disability

This is a more serious disease, it is impossible to cure it, the changes are irreversible, and the consequences are deadly. In other words, these two terms relate to each other as follows: dysfunction is primary, and failure is secondary.


Signs of diastolic dysfunction of the left ventricle make themselves felt when serious changes have already begun in the body. The list of characteristic symptoms:

  • Heartbeats become more frequent both in an active state and in a calm state.
  • A person cannot take a deep breath, as if the chest were constricted.
  • Attacks of dry cough indicate the appearance of stagnation in the lungs.
  • Any minor effort is difficult.
  • Shortness of breath occurs both when moving and at rest.
  • More frequent attacks of nocturnal apnea are also an indicator of malfunctions in the left ventricle.
  • Another symptom is swelling of the legs.
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The main reasons for the deterioration of relaxation of the left ventricle are hypertrophy of its walls and their loss of elasticity. Various factors lead to this condition:

  • arterial hypertension;
  • aortic stenosis;
  • cardiomyopathy;
  • heart rhythm disturbances;
  • myocardial ischemia;
  • age changes;
  • gender factor (women are more susceptible);
  • abnormal condition of the coronary arteries;
  • inflammation of the pericardium of the constrictive type;
  • overweight;
  • diabetes;
  • heart defects;
  • heart attack.


The essence of the treatment of diastolic dysfunction of the wall of the left ventricle is reduced to the restoration of blood circulation. To do this, you must:

  • eliminate tachycardia;
  • keep your blood pressure normal;
  • normalize metabolism in the myocardium;
  • minimize hypertrophic changes .-

List of the main drugs used for medicinal purposes:

    7d2aa368bd2e062a901062ece58e7e7a - Diastolic dysfunction of the left ventricle type 1 disability

  • adrenal receptor blockers;
  • calcium channel inhibitors;
  • drugs from the group of sartans and nitrates;
  • cardiac glycos >

    Among the most commonly used drugs are: “Carvedilol”, “Digoxin”, “Enalapril”, “Diltiazem”.

    Diastolic dysfunction can be diagnosed mainly with the help of echocardiography, echocardiography, supplemented by Doppler study, ECG, laboratory tests.

    Diastolic dysfunction of the left ventricle is a pathology that requires careful attention. Untimely access to a doctor can turn out to be an unpleasant prognosis for a person: disability or death.

    People with a history of cardiac disease should be especially careful about their health. Together with the main drug therapy, it is recommended to treat myocardial dysfunction with home remedies.

    Traditional medicine recipes can be found in large numbers on the Internet.

    The content of the article

    • What it is?
    • >524fed5d30a7310dfe77629f6bccbb98 - Diastolic dysfunction of the left ventricle type 1 disability

    When the diastolic function of the left ventricle is impaired, the muscle tissues of the myocardium lose their ability to relax at the time of diastole. As a result, the ventricle does not receive the necessary amount of blood. To compensate for its lack, the left atrium is forced to intensify its work, trying to absorb more blood.

    All this negatively affects the state of the atrium, gradually leads to overload, its increase in size.

    Against the background of systolic dysfunction, stagnation in the venous system and lungs can occur, which entails interruptions in the blood supply to all organs of the human body.

    The transition of this pathological condition to a more severe form can lead to the occurrence of chronic heart failure.

    Diastole is important, because thanks to it, the heart muscle receives the necessary oxygen, which is carried through the circulatory system through the coronary arteries.

    If she is unable to fully perform her tasks, the left ventricle suffers from oxygen deficiency. This leads to metabolic disorders in the tissues of the myocardium and ischemia.

    Prolonged ischemia is detrimental to cells, instead of which connective tissue is formed. This process is called sclerosis or fibrosis. An altered tissue structure causes a difficult contraction of the left ventricle. Ultimately, systole failure occurs.


    The first type of disease is the most common. It is fraught with serious danger, since at the initial stage of development it proceeds practically without any symptoms. It is characterized by a decrease in the ability to distill blood into the ventricle from a paired blood vessel of the pulmonary trunk. The reason for this is the lack of elasticity of the walls of the myocardium.

    The second type of ailment manifests itself against the background of increased pressure from the left atrium, which leads to impaired diastole function. It is also called pseudo-normal.

    The most severe is the restrictive type of pathology, when there is a threat to human life, in connection with serious violations in the heart. In such situations, a heart transplant is usually performed.

    If a person has type 1 diastolic dysfunction of the left ventricle, edema, which is observed mainly in the evening, may indicate this. This condition is due to stagnation of fluid in the body. Swelling is usually noted on the lower extremities.

    In this case, the patient may complain of heart pain caused by myocardial ischemia. Often after physical activity shortness of breath appears. Diastolic dysfunction of the left ventricle of type 1 should not be ignored, it requires medical correction.

    At the initial stage of development, the disease may not even manifest itself. In the absence of proper treatment, it will progress, as a result of which the following signs of left ventricular diastolic dysfunction may appear:

    • 1b41c613e9e3b5d286ca122d4326498e - Diastolic dysfunction of the left ventricle type 1 disabilityshortness of breath at rest or after minor physical exertion;
    • increased heart rate;
    • feeling of tightness in the chest area and lack of oxygen;
    • swelling of the lower extremities;
    • bluish color of the skin;
    • fatigue;
    • heart pain.

    It is extremely rare for patients to have a cough that occurs in the evening. Its appearance indicates the presence of congestion in the lungs.

    35cc8f78af6c182e5403758b52d94072 - Diastolic dysfunction of the left ventricle type 1 disability

    The blood flow in the heart goes through 3 stages:

    • muscle relaxation (diastole);
    • slow filling of the left ventricle with blood, provided by the pressure difference inside the atria;
    • filling the left ventricle with the remaining blood after contraction of the heart.

    We are talking about diastolic dysfunction when there is any failure in such a debugged system. Pathology of this type can occur due to the presence of the following factors:

    • old age;
    • myocardial infarction;
    • impaired blood flow in the cardiovascular system;
    • overweight;
    • hypertension;
    • myocardial dysfunction.

    Deviations in the work of the heart provoke addictions in the form of smoking and drinking alcohol. Not the best way on the condition of the heart muscle affects the love of caffeinated drinks.

    Ventricular myocardial dysfunction: causes, symptoms, treatment

    The following treatment measures should be attributed to methods for correcting hemodynamic disorders:

    • control of blood pressure;
    • decreased heart rate;
    • maintaining water-salt metabolism to reduce preload;
    • remodeling of left ventricular hypertrophy.

    The main groups of drugs used for treatment are:

    1. Adrenergic blockers – reduce the heart rate, reduce blood pressure, and improve the processes of nutrition of myocardial cells.
    2. Angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor antagonists (sartans) are two classes of drugs that have similar effects: a positive effect on myocardial remodeling, improving its elasticity, lowering blood pressure, and reducing preload. They have a proven positive effect on the prognosis, life expectancy and improvement of its quality in patients with chronic heart failure.
    3. Diuretics – due to the removal of excess fluid, reduce the manifestations of shortness of breath, in combination with drugs of other antihypertensive classes contribute to more effective control of blood pressure. Assigned in small doses, as they can lead to a significant reduction in stroke volume.
    4. Calcium antagonists – have a direct positive effect on diastolic dysfunction: due to a decrease in calcium in myocardiocytes, they contribute to myocardial relaxation. In addition, they lower blood pressure. They are the drugs of choice for intolerance to adrenergic blockers.
    5. Nitrates belong to an additional group of drugs, their appointment is possible in the presence of signs of myocardial ischemia, proven instrumental.

  • Svetlana Borszavich

    General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
    Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
    The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
    The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.