METHOD OF EVALUATION OF RELAXATION AND DI ASTOLIC FUNCTION

Impairment of relaxation and diastole is usual if not constant in card iomyopathies and accompanies a disorder of cardiac contractile functio n. Certain heart diseases, especially hypertrophic cardiomyopathy, are associated with relative preservation vation of contractility and the predominant disorder concerns left ventricular filling. The clinical consequence of this impairment is dyspnoea due to elevated pressures o f the left-sided cavities. The loss of atrial systole atrial is usuall y very-poorly tolerated. There is an ambiguity of definitions, as, for the clinician, diastole starts at the time of closure of the aortic v alve and consists of four phases: isometric relaxation, rapid ventricu lar filling, diastasis and atrial systole. In reality, this definition must be reviewed in physiological terms, asthe relaxation which allow s the:he ventricle to return to its initial precontraction configurati on is Bn active phenomenon which is actually part of ventricular systo le. The reference methods of investigation remain haemodynamic methods with invasive measurements of left ventricular pressures and volumes. Myocardial isotope scan and especially echocardiography allow assessm ent of relaxation and diastole, although certain limitations of interp retation must be kept in mind. In terms of treatment, the demonstratio n of impairment of relaxation and diastole may require a different app roach when contractile function is preserved. Calcium channel blockers could be useful and the preservation of atrial systole is always deci sive.