Garcia M J
Department of Cardiology, Cleveland Clinic, USA.
Cleve Clin J Med. 2000 Oct;67(10):727-9, 733-8. doi: 10.3949/ccjm.67.10.727.
Diastolic dysfunction is the underlying problem in one third of patients with heart failure, but it is still not well understood. Carefully excluding other causes of heart failure and recognizing indicators of diastolic dysfunction on invasive and noninvasive tests are important in establishing the diagnosis and in guiding therapy. Left ventricular relaxation and stiffness and left atrial function are the most important factors acting together to maintain adequate cardiac output under normal filling pressure. Echocardiography is the most important tool for the diagnosis of diastolic heart dysfunction. It is portable, safe, and excludes other causes of heart failure, such as valvular disease. Diuretics can be used to reduce volume overload, but caution is advised, as aggressive diuresis decreases stroke volume more in diastolic dysfunction than in systolic dysfunction.
舒张功能障碍是三分之一心力衰竭患者的潜在问题，但目前仍未被充分理解。在确立诊断和指导治疗过程中，仔细排除心力衰竭的其他病因并识别侵入性和非侵入性检查中舒张功能障碍的指标非常重要。左心室舒张和僵硬度以及左心房功能是在正常充盈压下共同维持足够心输出量的最重要因素。超声心动图是诊断舒张性心力衰竭的最重要工具。它便于携带、安全，且可排除心力衰竭的其他病因，如瓣膜疾病。利尿剂可用于减轻容量超负荷，但建议谨慎使用，因为在舒张功能障碍中，积极利尿导致的每搏输出量减少比收缩功能障碍中更明显。
