Biologist's view on diastolic dysfunction
Swynghedauw, B.
Archives des Maladies du Coeur et des Vaisseaux 84 Spec no 3: 97-100
1991
ISSN/ISBN: 0003-9683 PMID: 1835366 Document Number: 369478
Modern biology provides satisfactory explanations for the abnormalities of the different phases of relaxation and diastole. Ventricular filling depends on three factors: active relaxation; the only factor is the concentration of ATP which has to re-increase. This requires elimination of the cytoplasmic calcium which activates ATP-ase by the Ca2+ ATPase of the sarcoplasmic reticulum and the Na+/Ca2+ pump. In hypertrophy, the concentration of the first and the activity of the second are decreased; passive wall compliance, which depends on the quantity and quality of parietal collagen. This factor is partially regulated in the myocardium by the concentration of aldosterone and angiotensin II; atrial contraction, which depends on the size of the atria and their isomyosine content. This changes in atrial overload to a slow form of myosine, one of the mechanisms of adaptation.