diastolic dysfunction

[allenmarie]

I have a friend that has a heart problem. He has been diagnos with diastolic dysfunction grade 2. Is there any cure on his illness? or any surgery that can treat this kind of heart abnormality? the latest result of his lab test is as follows:Normal left ventricular dimension with adequate wall motion and contractility (ejection fraction = 59%) but with doppler evidence of diastolic dysfunction grade 2 (reduce compliance).Dilated left atrium (4.0cm) probably secondary to left ventricular diastolic dysfunction.Floppy anterior mitral valve leaflet with doppler evidence of trivial mitral regurgitation.

Im worried on his condition he is only 30 years old. please explain and give an advice. thanks.

[kenkeith]

For a perspective, diastole dysfunction compromises left ventricle filling volume, inadequate stroke volume and operating at a high pressure regimen.  LV filling volume is reduced due to increased wall size crowding out available space.  Inadequate stroke volume is usually due to wall thickening and stiffening and loss of elasticity.  High pressures can dilate upper chamber to compensate for gradient pressure across the mitral valve. That is the pathology.

DD grade 2, the indivdual has slight, mild limitation of activity and comfortable with with rest or mild exertion. May alternate with grade ! indicating no symptoms.  Gradient pressure has dilated LA (4.0cm) slightly if at all (its estimate).  Normal range is 1.9 to 4.0 cm.  

Trivial mitral regurgitation is slight backflow of blood from the LV to LA and not significant enough to be of any concern. Probably a result of the gradient pressure or congenital.  Many individuals have some leakage.

EF is normal (normal 55-75%) indicating the contractility of the left ventricle is preserved.  With DD the EF can be abnormal or normal.  Progression of DD can/will increase LV dimension causing a loss of contractility and heart failure (EF below 29% )if not treated and the right circumstances.

The underlying cause determines treatment and prognosis.  Systemic hypertension is the major cause.  Medication to reduce hp (if relevant), beta blocker to control heart rate (fast heart rate can be veryproblematic as it reduces the time to fill), etc. or there can be neurofibromatosis or pheochromocytoma (pathological growth of heart walls).

I wish your friend well, and I have provided worst case scenario.