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揭示左心室舒张功能障碍:病理生理学、诊断及治疗策略

Unmasking Left Ventricular Diastolic Dysfunction: Pathophysiology, Diagnosis, and Treatment Strategies.

作者信息

Vlasopoulou Konstantina, Synetos Andreas, Ktenopoulos Nikolaos, Katsaros Odysseas, Koliastasis Leonidas, Apostolos Anastasios, Drakopoulou Maria, Toutouzas Konstantinos, Tsioufis Constantinos

机构信息

First Department of Cardiology, Hippokration General Hospital of Athens, National and Kapodistrian University of Athens, 11527 Athens, Greece.

School of Medicine, European University of Cyprus, 2404 Egkomi, Cyprus.

出版信息

Med Sci (Basel). 2025 Sep 22;13(3):204. doi: 10.3390/medsci13030204.

Abstract

Left ventricular diastolic dysfunction (LVDD) is characterized by impaired ventricular relaxation and increased chamber stiffness during diastole, resulting in increased left ventricular filling pressures. It represents a highly prevalent yet frequently underdiagnosed cardiac condition with significant clinical implications, serving as a major contributor to heart failure with preserved ejection fraction (HFpEF), particularly among elderly individuals and those with hypertension, diabetes mellitus, obesity, or coronary artery disease. Multiple studies have identified the progression of LVDD as a marker of adverse prognosis, associated with increased morbidity and mortality, highlighting the importance of early recognition and targeted therapeutic strategies to improve diastolic function and clinical outcomes. This review summarizes the pathophysiology, current diagnostic strategies, and treatment options for LVDD, emphasizing its importance in clinical practice.

摘要

左心室舒张功能障碍(LVDD)的特征是心室舒张期松弛受损和心室僵硬度增加,导致左心室充盈压升高。它是一种高度常见但经常被漏诊的心脏疾病,具有重大临床意义,是射血分数保留的心力衰竭(HFpEF)的主要促成因素,在老年人以及患有高血压、糖尿病、肥胖症或冠状动脉疾病的人群中尤为常见。多项研究已确定LVDD的进展是不良预后的标志,与发病率和死亡率增加相关,凸显了早期识别和针对性治疗策略以改善舒张功能和临床结局的重要性。本综述总结了LVDD的病理生理学、当前诊断策略和治疗选择,强调了其在临床实践中的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17d2/12471323/60680d634363/medsci-13-00204-g001.jpg

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