Department of Cardiovascular Medicine, Division of Nutrition and Preventive Medicine, William Beaumont Hospital, Third Floor West Tower, 3601 West 13 Mile Road, Royal Oak, MI 48073, USA.
Curr Cardiol Rep. 2010 May;12(3):216-22. doi: 10.1007/s11886-010-0101-1.
Coronary artery disease is present in 40-55% of patients with diastolic heart failure, and myocardial ischemia is both a cause and a precipitant of diastolic heart failure. Failure to recognize and treat acute and chronic ischemia in patients with this disorder results in rapid disease progression and poor outcomes. In diastolic heart failure patients without obstructive coronary artery disease, ischemia can be induced by other diseases that diminish perfusion gradient, cause myocardium to outgrow blood supply, or decrease diastolic filling time. In this article, we review the role of ischemia and development of fibrosis in the epidemiology, pathophysiology, and evaluation of patients with diastolic dysfunction and diastolic heart failure.
在舒张性心力衰竭患者中，40-55%存在冠状动脉疾病，心肌缺血既是舒张性心力衰竭的病因，也是其诱发因素。若未能识别和治疗此类患者的急性和慢性缺血，会导致疾病迅速进展和预后不良。在无阻塞性冠状动脉疾病的舒张性心力衰竭患者中，缺血可由其他疾病引起，这些疾病会降低灌注梯度、导致心肌过度生长而超出血液供应、或缩短舒张充盈时间。本文回顾了缺血和纤维化在舒张功能障碍和舒张性心力衰竭患者的流行病学、病理生理学和评估中的作用。
