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Comparative studies of systolic and diastolic function of the left ventricle in patients with dilated cardiomyopathy.

The main haemodynamic disturbance in dilated cardiomyopathy (DCM) is deterioration of systolic function of the left ventricle, while impairment of diastolic function demands more careful investigation. The purpose of the study was to analyse the relationship between the degree of dysfunction of the ventricle as a pump and diastolic dysfunction. During diastole, isovolumetric relaxation and myocardial compliance were assessed. Thirty nine patients with DCM underwent heart catheterization. The following results were obtained: an increase in LVMPD, LVEDP, LVESVI, LVEDVI and T; a decrease in EF, +dp/dt max, -dp/dt min, the (+dp/dt max)/(-dp/dt min) ratio was normal. There was a statistical correlation between: T and LVMDP (r = 0.79; p less than 0.001) and LVEDP (r = 0.67; p less than 0.001) as well as between LVEDVI and +dp/dt max (r = -0.67; p less than 0.001) and -dp/dt min (r = -0.64; p less than 0.001). It is concluded that in DCM: 1. the impairment of systolic and diastolic function progresses simultaneously, 2. disturbances in isovolumetric relaxation are dominant in relation to the filling phase deterioration.