DIASTOLIC HEART FAILURE: POSSIBILITIES OF DIAGNOSIS AND CHOICE OF ADEQUATE THERAPY

Cardiac fibrosis has recently generated great interest among clinicians and physiologists. Particular attention has been given to the role of fibrosis in the development of diastolic dysfunction and as a consequence in the occurrence of chronic heart failure with preserved ejection fraction. Myocardial biopsy with determination of the interstitial collagen volume fraction is considered to be the gold standard for qualitative and quantitative assessment of myocardial fibrosis. The histological signs of the latter are detectable just in the early stages of hypertension in patients with moderate left ventricular hypertrophy. However, lifetime endomyocardial biopsy is a traumatic diagnostic technique, thus the development of non-invasive readily accessible methods is of great importance. It is no less important to elaborate general criteria for the early diagnosis of diastolic heart failure, as well as methods for its treatment and prevention.

heart failure, preserved ejection fraction, myocardial fibrosis, diastolic dysfunction, central pressure, vascular wall stiffness, renin-angiotensin-aldosterone system