Can diastolic dysfuncion cause heart failure even if you have hyperdynamic systolic function?

[RITZGAL]

Can diastolic dysfunction cause symptoms of heart failure?  I have left ventricular hypertrophy with hyperdnamic systolic function.  I have shortness of breath and chest pain with exercise or climbing stairs, and sometimes swollen legs.  I was told it was diastolic heart failure.  EF is normal to above normal.  Left ventricle is stiff.  Cath results are:  pcwp: 23mm, pulmonary artery 45/23 mm, right atrium mean 17mm, right ventricle 45/17 mm, lvedp is 23mm.  I don't know what these numbers mean.  If you can tel from numbers, is my condition mild, moderate or severe?  Taking diovan and toprol xl, diuretics, lipitor.  Swelling is better, but still feel the same with exercise.  Getting cramps in ribs and toes.  Potassium is 2.5 to 2.8 with taking 20 mq pot chl x 3 daily.  Seems I either have muscle cramps or swelling.  Can hypertrophy reverse if I stay on meds long enough?  Thanks.

[RITZGAL]

Thank you so much.   Had another cath last month.  Happy to say numbers were better.  Meds are definitely helping.  

[kenkeith]

The PAC directly measures pulmonary pressures, including the pulmonary capillary wedge pressure (PCWP) as an estimate of LV preload (LVEDV), and indirectly measures CO (cardiac output).  The PCWP is a measure of capillary hydrostatic pressure, with a PCWP of more than 23 mm Hg usually representing extravasation of fluid into the alveoli (edema) when there is normal oncotic pressure (? NOT STATED)

Its not stated whether there is valve stenosis or regurgitation.  Your system is not in decompensation evidenced by hyperdynamic systole function, but if not properly and successfully treated you EF will drop to below 30% (heart failure range).

Usually measuring of  PCWP is to diagnose the severity of left ventricular failure and to quantify the degree of mitral valve stenosis. Both of these conditions elevate LAP (left atrial pressure) and therefore PCWP. These pressures are normally 8-10 mmHg.... not stated if there is aortic valve stenosis and/or mitral regurgitation and that will also elevate LAP. When these pressures are above 20 mmHg, pulmonary edema are likely to be present, which is a life-threatening condition.

PCWP is necessary to measure when evaluating pulmonary hypertension. Pulmonary hypertension is often caused by an increase in pulmonary vascular resistance. To calculate this, pulmonary blood flow (usually measured by the thermodilution technique), pulmonary artery pressure and pulmonary venous pressure (PCWP) measurements are required. Pulmonary hypertension can also result from increases in pulmonary venous pressure and pulmonary blood volume secondary to left ventricular failure or mitral or aortic valve disease".The following table shows the normal range of pressures for the RA, RV, PA, and PCWP:

Circulatory Pressures (mm Hg)

                        Systole    Diastolic      
Left ventricle (LV)  120        8 -
Left atrium (LA)        7      10                
Pulmonary artery    15        7                
Righr venticle          15        2 -
Right atrium             4       4 0
PCWP                     7       10                
  
  

[denisejoy]

I also have been diagnosed with moderate diastolic dysfunction.  Noticed you stated that if you let it get out of control you notice symtoms, (I have symptoms on & off as well).  Can you give me any info on how you keep it under control?  How long have you had "moderate" DD to you knowlege?  Thanks so much!  Also, we it be stopped and/or reduced?

[RITZGAL]

CAN ANYONE DECIPHER THESE NUMBERS?  I have left ventricular hypertrophy with hyperdnamic systolic function.  I have shortness of breath and chest pain with exercise or climbing stairs, and sometimes swollen legs.  I was told it was diastolic heart failure.  EF is normal to above normal.  Left ventricle is stiff.  Cath results are:  pcwp: 23mm, pulmonary artery 45/23 mm, right atrium mean 17mm, right ventricle 45/17 mm, lvedp is 23mm.  I don't know what these numbers mean.  If you can tel from numbers, is my condition mild, moderate or severe?  Taking diovan and toprol xl, diuretics, lipitor.  Swelling

[RITZGAL]

Thanks for your response.  Yes, I do remember dr. saying that my resting heartrate was 90-95 beats per minute and he needed to slow it down.  I had untreated high blood pressure for a number of yrs.  That may have caused.  I dont know if he ever pinned it down.  He also said once that I had hypertrophic cardiomyopathy, but I dont know if that was just another way of saying "stiff heart muscle".  When we got my heart rate down to 66 and blood pressure down to 108/66, I couldnt function.  He said some people cant and adjusted my meds.  Now my blood pressure is 118/72 and heart rate is about 72.  I at least feel normal until I do some stairs.  I will check on how much exercise is ok.  Thank you again.  I hope this finds you well.

[kevk]

Diastolic Dysfunction can cause the same symptoms of heart failure. I can not tell you from your numbers what level you may have.  I have moderate diastolic dysfunction if I let it get out of control it gives me the same symptoms of congestive heart failure, Shortness of breath,Chest pain, fatigue. Depending on what caused your hypertrophy some forms can be reversed.
   Doctors will give you meds to slow your heart and give it more time to fill with blood. Check with your doctors about exercising make sure you are not overdoing it.