Left Ventricular Diastolic Dysfunction in the Critically Ill

摘要: Intrinsic left ventricular (LV) cardiac pump function plays a major role in defining cardiovascular reserve and the ability of the host to respond to circulatory stress. The three major processes defining myocardial contractile reserve relate to processes directly altering systolic pump function, contraction synchrony and diastolic relaxation. The most common process limiting intrinsic cardiac performance worldwide is diastolic dysfunction. Diastolic dysfunction increases perioperative risk and hemodynamic derangement in the intensive care unit (ICU). In the unstressed state, diastolic dysfunction often exists at a subclinical level, becoming overtly manifest only during stress states as seen with acute hypovolemic or distributive shock and in the management of acute respiratory failure. Preoperative diagnosis often requires exercise testing because patients are usually asymptomatic at rest. Diastolic dysfunction often …