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Diastolic dysfunction, diagnostic and perioperative management in cardiac surgery

Nicoara, Alina; Swaminathan, Madhav

Current Opinion in Anaesthesiology: February 2015 - Volume 28 - Issue 1 - p 60–66
doi: 10.1097/ACO.0000000000000141
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Purpose of review The review focuses on recent findings on the role of diastolic dysfunction in the perioperative period and on recent advances in the diagnosis and perioperative management of diastolic function.

Recent findings Left ventricular diastolic dysfunction is an underestimated disease with a high risk for acute decompensation in the perioperative period. It has been associated with adverse outcomes in patients undergoing cardiac or noncardiac procedures. Recent advancements in the diagnosis of diastolic function have limited intraoperative applicability. Due to the lack of disease-specific therapies, perioperative management is preventive and symptomatic.

Summary Appropriate perioperative patient care requires that the perioperative physician be alerted to the presence of diastolic dysfunction, be knowledgeable of the diastolic dysfunction grading system and understand the pathophysiologic changes associated with various grades of diastolic function

Division of Cardiothoracic Anesthesiology and Critical Care Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA

Correspondence to Alina Nicoara, MD, FASE, Box 3094/5691F HAFS, DUMC Anesthesiology, Erwin Rd, Durham, NC 27710, USA. Tel: +1 919 681 0862; fax: +1 919 681 8994; e-mail:

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