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Journal of Biomedicine and Biotechnology
Volume 2010 (2010), Article ID 807084, 12 pages
http://dx.doi.org/10.1155/2010/807084
Review Article

Physiologic Basis and Pathophysiologic Implications of the Diastolic Properties of the Cardiac Muscle

Department of Physiology, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal

Received 1 November 2009; Revised 15 February 2010; Accepted 21 March 2010

Academic Editor: Henk L. M. Granzier

Copyright © 2010 João Ferreira-Martins and Adelino F. Leite-Moreira. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Although systole was for long considered the core of cardiac function, hemodynamic performance is evenly dependent on appropriate systolic and diastolic functions. The recognition that isolated diastolic dysfunction is the major culprit for approximately fifty percent of all heart failure cases imposes a deeper understanding of its underlying mechanisms so that better diagnostic and therapeutic strategies can be designed. Risk factors leading to diastolic dysfunction affect myocardial relaxation and/or its material properties by disrupting the homeostasis of cardiomyocytes as well as their relation with surrounding matrix and vascular structures. As a consequence, slower ventricular relaxation and higher myocardial stiffness may result in higher ventricular filling pressures and in the risk of hemodynamic decompensation. Thus, determining the mechanisms of diastolic function and their implications in the pathophysiology of heart failure with normal ejection fraction has become a prominent field in basic and clinical research.