Diastolic Heart Failure - Risk Factors and Causes

Risk Factors and Causes

Any condition or process that leads to stiffening of the left ventricle can lead to diastolic dysfunction. Causes of left ventricular stiffening include:

• High blood pressure (i.e. hypertension, where - as a result of left ventricular muscle hypertrophy to deal with the high pressure - the left ventricle has become stiff)
• Aortic stenosis of any cause (here, as with hypertension, the ventricular muscle has hypertrophied and thence become stiff as a result of the increased pressure load placed on it by the stenosis)
• Scarred heart muscle (e.g. that occurring after a heart attack). Scars are relatively stiff tissue compared to normal myocardium
• Diabetes (stiffening occurs, presumably, as a result of glycosylation of heart muscle)
• Severe systolic dysfunction that has led to ventricular dilation (i.e. when the ventricle has been stretched to a certain point, any further attempt to stretch it more - as by blood trying to enter it from the left atrium - meets with increased resistance due to increased stiffness)
• Reversible stiffening, as can occur during periods of cardiac ischemia

Causes of isolated right ventricular stiffening are uncommon. These causes include:

• Constrictive cardiomyopathy
• Restrictive cardiomyopathy, which includes Amyloidosis (most common restrictive), Sarcoidosis and fibrosis.