Department of Cardiology and Pneumology, Benjamin Franklin Campus, Charité University Hospital, Berlin, Germany.
Curr Pharm Biotechnol. 2012 Oct;13(13):2539-44.
Our knowledge of diastolic heart failure (DHF) is still limited with regard to pathophysiology, diagnosis and clinical treatment. Amongst others, LV dyssynchrony was suggested to be an additional factor involved in the pathogenesis of subgroup of patients with DHF. In 20-30% of patients with DHF a systolic LV dyssynchrony could be detected and about 20% DHF patients evidenced a diastolic dyssyncrony. Both systolic and diastolic dyssynchrony may contribute to the impairment of cardiac function and clinical manifestation in DHF. Opposite to the systolic heart failure, wide QRS complex is uncommon which incriminates that dyssynchrony in DHF is rather related to regional disperse in contractility than to electromechanical coupling delay. Asynchronous LV relaxation and impairment of ventricular restoring forces may also impair the LV filing and lead to a diastolic dyssynchrony. Particularly in patients with preserved LV contractility mechanical LV dyssynchrony induces energy wastage and consequently reduces cardiac reserves. However, up to date it is not clear to what degree LV dyssynchrony is involved in the pathomechanisms of this subpopulation of DHF.
我们对舒张性心力衰竭（DHF）的了解在病理生理学、诊断和临床治疗方面仍然有限。其中，左心室不同步被认为是 DHF 亚组患者发病机制中的一个附加因素。在 20-30%的 DHF 患者中可以检测到收缩性 LV 不同步，约 20%的 DHF 患者存在舒张不同步。收缩性和舒张性不同步均可导致 DHF 中心脏功能和临床表现的损害。与收缩性心力衰竭相反，宽 QRS 复合物并不常见，这表明 DHF 中的不同步与其说是与电机械偶联延迟有关，不如说是与收缩力的区域性分散有关。LV 松弛不同步和心室恢复力受损也可能损害 LV 充盈，并导致舒张不同步。特别是在保留 LV 收缩力的患者中，机械性 LV 不同步会导致能量浪费，从而降低心脏储备。然而，迄今为止，还不清楚 LV 不同步在 DHF 这一亚群的发病机制中涉及到何种程度。
