Uma utshelwe ukuthi une- diastolic ukungasebenzi noma ukwehluleka kwenhliziyo ye-diastolic , kubalulekile kuwe nodokotela wakho ukuba wenze uhlelo lokuphulukisa - kokubili ukuvimbela nokulawula izimpawu zakho, nokunciphisa amathuba okufa kulokhu.
Isu Lokunakekelwa Kwe-Diastolic Dysfunction
Isu esihle kunazo zonke sokwelapha ukukhubazeka kwe-diastolic, kunoma yiliphi izinga lobukhulu, ukuzama ukukhomba noma yiziphi izimo ezithintekayo, bese uziphatha ngokuhlukumezayo.
Ikakhulukazi, lezi zindlela ezilandelayo kumele zibhekiswe kuzo:
Indlela yokuphila yama-sedentary
Abantu abaningi abane-diastolic ukungasebenzi kahle bahola ukuphila okuhlala phansi, futhi ukuhlala phansi kuyimbangela enkulu ezinkingeni zenhliziyo ye-diastolic. Uhlelo lokuqeqeshwa kokuvivinya umzimba lwe-aerobic lungathuthukisa umsebenzi we-diastolic wenhliziyo futhi kungasiza kakhulu ekusebenziseni kwe-diastolic. Eqinisweni, uhlelo lokuzivocavoca luwukuphela kokwelashwa okuye kwaboniswa ukuthuthukisa ikhwalithi yokuphila ezigulini ezinalezi zimo. Kufanele ukhulume nodokotela wakho ngokukudlulisela ohlelweni lokuvuselela inhliziyo ukuqala.
I-hypertension.
Kufanele uhlolwe ngokucophelela nge- hypertension . I-hypertension ivame ukuvela kubantu abanokukhubazeka kwe-diastolic, futhi kungaba yinkimbinkimbi ukuxilonga. Okubi kakhulu, ukucindezeleka ngokweqile kuvame ukuphathwa ngokungafanele. Kodwa uma une-diastolic ukungasebenzi, kubaluleke kakhulu ukuthi udokotela wakho anakekele ngokucophelela ukuze aqiniseke ukuthi ukucindezeleka kwegazi kusezingeni elihle.
Isifo se-artery Coronary. (I-CAD)
Abantu abane-dysfunction diastolic kufanele futhi bahlolwe ngokuba khona kwe- coronary artery disease (CAD) ; uma kutholakala i-CAD, kufanele iphathwe kabi. I-Occult (okungukuthi, engahloliswanga futhi engacabangi) I-CAD iyimbangela evamile yokungasebenzi kwe-diastolic.
I-fibrillation ye-Atrial.
Uma une -fibrillation ye-atrial , lesi siguli se-cardiac kufanele siphathwe ngokwanele. Kubantu abane-diastolic ukungasebenzi kanye ne-fibrillation ye-atrial, isu lokulawula isigqi ngokuvamile likhethwa phezu kwecebo lokulawula izinga. (Funda mayelana nokulawula isigqi nokulinganisa izinga lokufibhala kwe-atrial .) Nokho, uma isigqi senhliziyo evamile singenakugcinwa, kubaluleke kakhulu ukuthola isilinganiso senhliziyo ngaphansi kokulawula Lokhu kungenxa yokuthi amazinga enhliziyo avame ukubangelwa yi-fibrillation ye-atrial angabangela ukuwohloka okukhulu komsebenzi wenhliziyo kubantu abane-diastolic ukungasebenzi.
Isifo sikashukela nokukhuluphala.
Isifo sikashukela nokukhuluphala kokubili kuhlotshaniswa nokukhubazeka kwe-diastolic. Ukulahlekelwa isisindo nokugcina isifo sikashukela ngaphansi kokulawulwa kahle kungasiza ekuvimbeleni ukukhubazeka kwe-diastolic ukungasebenzi.
Ukuphefumula okuphazamisekile
Ukuphazamiseka okuphefumulayo ngesikhathi sokulala, ikakhulukazi izimo zokuphefumula , kungasiza kakhulu ekusebenziseni i-diastolic ukungasebenzi. Abantu abanokukhubazeka kwe-diastolic - ikakhulukazi uma bekhululekile noma banezimpawu ezibonisa ukuphefumula okuphazamisekile kokulala - kufanele bahlolwe ngenxa yokuphefumula, futhi uma kutholakala ukuthi kufanele baphathwe.
Ukwelashwa kokuhluleka kwenhliziyo ye-Diastolic
Ukwelapha ukwehluleka kwenhliziyo ye-diastolic (okuyinto izazi ze-cardiologists manje ezibhekisela kuzo ngokuthi "ukuhluleka kwenhliziyo nge- fraction ejection fraction ") kungaba yinselele. Ngokungafani nokuhluleka kwenhliziyo ye-systolic yakudala , lapho izifundo eziningi zembule imithi ethile yokwelapha izidakamizwa ezithuthukisa kakhulu ukufa, azikho izifundo ezinjalo ezitholakalayo zokuhluleka kwenhliziyo ye-diastolic. Ngaphezu kwalokho, ngoba ama-ventricles e-diastolic inhliziyo ukwehluleka kwenhliziyo amancane futhi eqinile (kunokuba ahlanjululwe futhi ahlanzeke), izidakamizwa eziningi ezivame ukusetshenziselwa ukwehluleka kwenhliziyo ye-classic zingakwazi ukuhlukumezeka kwenhliziyo ye-diastolic.
Ukwelashwa kwezidakamizwa nge-diastolic inhliziyo ukwehluleka kwenhliziyo kuvame ukulinganiselwa ekusebenziseni izidakamizwa ezifana ne-furosemide (Lasix) ukunciphisa ukwanda ngokweqile kwe-sodium namanzi emzimbeni, nokunciphisa izimpawu zokungqubuzana kwe-pulmonary kanye ne-edema. Izidakamizwa zokulawula isifo sofuba nazo zibalulekile.
Ngaphezu kwalokho, esivivinyweni se-TOPCAT, ukwelashwa nge-spironolactone (uhlobo lwe-diuretic) kubonakala kunciphisa isidingo sokubhedlela kubantu abane-diastolic inhlupho yenhliziyo, kodwa akunciphisanga izinga lokufa.
Kodwa ukwelashwa okubaluleke kunazo zonke ukuhluleka kwenhliziyo ye-diastolic ukulawula ngokuqinile izici ezifanayo, ezibalwe ngenhla, ezibalulekile ekuphatheni ukungasebenzi kwe-diastolic. Kulezi zifundo, ukuqeqeshwa kokuzivocavoca (ukungabi nesikhathi sokuhlala phansi) kuyindlela kuphela ekhonjisiwe kwizifundo zokwelashwa ukuthuthukisa kakhulu izinga lempilo kubantu abane-diastolic yehluleka inhliziyo.
Iyini Isibikezelo se-Diastolic Dysfunction?
Abantu abaye baba nesiqephu sokuhluleka kwenhliziyo ye-diastolic sinesimo senhliziyo esiyingozi, esesongela impilo. Nakuba ukuchazwa kwabo jikelele kungcono kakhulu kuneziguli ezine-classic systolic intukuthelo yenhliziyo, isancipha kakhulu. Yingakho noma ubani obenesifo senhliziyo ephuthumayo kufanele aphathwa ngokuhlukumezeka - ngokuzama ukulawula zonke izimo ezibhekene nalesi sifo.
Ngokuqondene nabantu abaye bathola ukuthi bane-diastolic ukungasebenzi kodwa abangenayo izimpawu zokuhluleka kwenhliziyo , ubufakazi buqoqa ukuthi laba bantu banokufa okuphezulu kunokuvamile. Lokhu kuthola akufanele kusimangaze uma ucabangela izimbangela eziyinhloko zokungasebenzi kahle kwe-diastolic, ukuqhutshwa kodokotela "ukwenza" okubili okujwayelekile kakhulu kulabo (okungukuthi, umfutho wegazi ophezulu kanye nesifo se-coronary artery), kanye nobunzima abantu abaningi abanalo ukushintsha izindlela zokuphila ezihlala phansi, nokulahlekelwa isisindo.
Ukukhubazeka kwe-Diastolic kuyimfuneko ebalulekile ukuthi, okungenani kufanele, ifune ukuhlola ngokucophelela izimbangela eziyinhloko, bese kuthi ukwelashwa okunonya. Ukwelashwa okwanele kwe-diastolic ukungasebenzi kungaba ngcono kakhulu amathuba okuba nomphumela omuhle.
> Imithombo:
> Borlaug BA, Paulus WJ. Ukungaphumeleli Inhliziyo Nge-Fraction Egcinwe Ekulondoloziwe: I-Pathophysiology, I-diagnosis, ne-Treatment. I-Eur Heart J 2011; 32: 670.
> Pitt B, uPfeffer MA, Assmann SF, et al. I-Spironolactone ye-Heart Failure ne-Preserved Ejection Fraction. N Engl J Med 2014; 370: 1383.
> Yancy CW, Jessup M, Bozkurt B, et al. Umhlahlandlela we-ACCF / AHA ka-2013 we-Management of Heart Failure: Umbiko we-American College of Cardiology Foundation / i-American Heart Association Task Force on Guidelines Practice. J Am Coll Cardiol 2013; 62: e147.