#diastolic function

Dr. Randy Martin: Heart failure is a major problem in this country, but there is a common type of heart failure that is often overlooked. I met with fellow cardiologist Dr. Winston Gandy to get his views on this condition.

Defining “heart failure”

“Heart failure occurs when the heart is unable to pump enough blood out of the heart, and either through leakage of the valves or the heart not squeezing normally, the condition raises the pressure in the lungs,” says Winston Gandy, M.D., a cardiologist at Piedmont Hospital. “This creates a sensation of shortness of breath.”

Dr. Gandy says that “heart failure” does not necessarily mean the heart is failing; it is rather a constellation of symptoms that cause the heart to not pump as well as it should.

Systolic vs. Diastolic Function of the Heart

“The squeezing component [of heart function] is the systolic function and the relaxing component is the diastolic function,” says Dr. Gandy. To determine a person’s blood pressure, physicians look at both of these functions. “When the heart squeezes, that will generate the top number, when the heart relaxes, that will result in the bottom number.”

Diastolic Dysfunction

A study from the Cleveland Clinic looked at outpatients who had echocardiograms, or ultrasound imaging of the heart, for various reasons. “Researchers looked at the flow patterns when the heart’s pumping chamber was being filled,” says Dr. Gandy. “What they noticed was a certain pattern that they termed ‘diastolic dysfunction.’ It turned out that a large group of individuals, the majority of patients, have some type of abnormality with that inflow.”

In this particular study, in those patients who had moderate and severe diastolic dysfunction, there was an increase in the incidence of heart failure events.

Who is at risk for diastolic dysfunction?

“Those with longstanding high blood pressure are at risk,” says Dr. Gandy. Patients who suffer from coronary heart disease are also at risk, as are some diabetics because they can experience diffused disease that causes scaring in the heart over time.

Treatment for diastolic dysfunction

“We want to treat the cause of the diastolic dysfunction, but most of the medicines we have available to us are multifactorial in what they can do,” says Dr. Gandy. He adds that doctors can choose to control hypertension, high blood pressure, renal failure or diabetes to treat diastolic dysfunction. “There may be drugs that not only help lower blood pressure, but also better enable the heart muscle itself to relax.”

His key message: “When you have moderate to severe diastolic dysfunction, it should prompt the clinician to look for other related issues so we can identify someone who may be at risk.”

Dr. Randy Martin: As Dr. Gandy noted, diastolic heart failure can lead to serious consequences. Remember that high blood pressure – especially if it’s not adequately treated – is one of the major causes of diastolic heart failure. While medication is one of the ways to treat hypertension or high blood pressure, key things you can do include cutting way back on salt in your diet, exercising regularly and losing weight. You should also know the symptoms of heart failure and be sure to check with your doctor if you have any.

Heart failure symptoms:

Shortness of breath

Dizziness

Fatigue

Fluid in the lungs

Swelling in the ankles

Irregular heartbeats

Chest pain

Nausea

Difficulty Sleeping