Ngati mwauzidwa kuti muli ndi vuto la diastolic kapena diastolic mtima kulephera , nkofunika kuti inu ndi dokotala mupange ndondomeko ya chithandizo - kuti muteteze ndi kulamulira zizindikiro zanu, ndi kuchepetsa mwayi wanu wakufa chifukwa cha vutoli.
Njira Yothandizira Opaleshoni ya Diastolic
Njira yabwino yothandizira odwala matenda a diastolic, mwa njira iliyonse yowopsya, ndiyo kuyesa kuzindikira zinthu zilizonse zomwe zimayambitsa, ndikuzigwiritsa ntchito molimba mtima.
Makamaka, zifukwa zotsatirazi ziyenera kuchitidwa:
Kukhala moyo wosadzikonda
Anthu ambiri omwe ali ndi vuto la diastolic amachititsa kuti moyo wawo ukhale wosakhalitsa, ndipo kukhala pansi kumathandiza kwambiri kuti vuto la mtima wa diastolic liyambe. Pulogalamu ya maphunziro ochita masewera olimbitsa thupi amatha kusintha ntchito ya diastolic ya mtima ndipo ikhoza kukhala yothandiza kwambiri kuwonongeka kwa diastolic. Ndipotu, purogalamu yochita masewero olimbitsa thupi ndiyo njira yokhayo yomwe yawonetseredwa kuti ikupangitse umoyo wa odwala omwe ali ndi vutoli. Muyenera kuyankhula ndi dokotala wanu za kukulozerani pulogalamu ya kukonzanso mtima kuti muyambe.
Kuthamanga kwa magazi.
Muyenera kuyang'anitsitsa mosamala kwambiri . Kuthamanga kwa magazi kumachitika kawirikawiri kwa anthu omwe ali ndi vuto loipa la diastolic, ndipo zingakhale zovuta kudziwa. Choipa kwambiri, matenda oopsa kwambiri nthawi zambiri amachiritsidwa. Koma ngati muli ndi vuto la diastolic, ndi kofunika kwambiri kuti dokotala wanu asamalire kwambiri kuti awonetse kuti kuthamanga kwanu kwa magazi kuli koyenera.
Matenda a mitsempha ya Coronary. (CAD)
Anthu omwe ali ndi vuto la diastolic ayenera kuyesedwa kuti athe kukhala ndi matenda odwala matendawa (CAD) ; ngati CAD imapezeka, imayenera kuchitiridwa nkhanza. Zochita zamatsenga (ndiko kuti, zosadziwika ndi zosawerengeka) CAD ndi chifukwa chofala cha kuwonongeka kwa diastolic.
Matenda a atrial.
Ngati muli ndi tizilombo toyambitsa matenda , mtima wamagetsiwu uyenera kuchitidwa mokwanira. Kwa anthu omwe ali ndi matenda oopsa a diastolic ndi fibrillation ya atrial, kachitidwe ka kayendedwe kamene kawirikawiri kamasankhidwa pa njira yowonongeka. (Werengani za kayendedwe ka rhythm vs. masewera olimbitsa thupi ). Komabe, ngati mtima wachibadwa sungathe kusungidwa, ndikofunika kwambiri kuti chiwerengero cha mtima chikulamulire Izi ndi chifukwa chakuti miyendo ya mtima yofulumira kwambiri yomwe imayambitsa matenda a atrial ingayambitse kuwonongeka kwakukulu kwa ntchito ya mtima mkati mwa anthu okhala ndi matenda osokoneza bongo.
Matenda a shuga ndi kunenepa kwambiri.
Matenda a shuga ndi kunenepa kwambiri zonsezi zimagwirizanitsidwa ndi zovuta za diastolic. Kutaya thupi ndi kusunga shuga pansi pa kulamulira bwino kungathandize kuchepetsa kuwonongeka kwa matenda a diastolic.
Kugona mpweya wosokonezeka
Matenda opweteka pa nthawi ya tulo, makamaka matenda obisala , amatha kupindulitsa kwambiri kuwonongeka kwa diastolic. Anthu omwe ali ndi vuto la diastolic - makamaka ngati ali oposa kapena ali ndi zizindikiro zosonyeza kupuma kosalekeza - ayenera kuyesedwa kuti apitirize kugona, ndipo ngati akupezeka kuti ayenera kuchitidwa chithandizo.
Kuchiza kwa Mtima wa Diastolic Kulephera
Kuchiza matenda a diastolic mtima (omwe akatswiri a cardiologists tsopano akutchulidwa kuti "mtima wosagwirizana ndi gawo losungunuka ,") zingakhale zovuta. Mosiyana ndi masewero olimbitsa mtima a systolic , momwe kafukufuku wambiri amavumbulutsira mankhwala omwe amachititsa kuti munthu asamwalire, palibe maphunziro otero omwe angapezeke chifukwa cha kuchepa kwa mtima. Kuwonjezera apo, chifukwa zowonongeka m'mitima ya mtima ndizochepa komanso zovuta (mankhwala osokoneza bongo ndi ovuta), mankhwala ambiri omwe amagwiritsidwa ntchito polepheretsa mtima wamtima amatha kuwononga kwambiri mtima wa diastolic.
Mankhwala osokoneza bongo kwa diastolic mtima kulephera nthawi zambiri amagwiritsidwa ntchito pogwiritsa ntchito zodzoladzola monga furosemide (Lasix) kuti achepetse mphamvu ya sodium ndi madzi m'thupi, komanso kuchepetsa zizindikiro za kusokonezeka kwa mpweya ndi edema. Mankhwala osokoneza bongo ndi ofunika kwambiri.
Kuwonjezera apo, mu mayeso a TOPCAT, chithandizo cha spironolactone (mtundu wa diuretic) chinkawoneka kuchepetsa kufunika kokhala ndi anthu odwala matenda a diastolic, koma sanachepetse kuchuluka kwa imfa.
Koma mankhwala ofunikira kwambiri odwala matenda a diastolic ndi kuwongolera molimba mtima zinthu zomwezo, zomwe zatchulidwa pamwambapa, zomwe ziri zofunika pochiza matenda osokoneza bongo. Mwa izi, kuchita masewera olimbitsa thupi (osakhala panthawi yopuma) ndiyo njira yokha yomwe yasonyezedwera m'maphunziro azachipatala pofuna kusintha kwambiri umoyo wa anthu omwe ali ndi vuto la mtima wa diastolic.
Kodi Chizindikiro cha Dysfunction Diastolic ndi chiyani?
Anthu amene akhala ndi vuto la mtima wa diastolic ali ndi vuto lalikulu la moyo. Ngakhale kuti zizindikiro zawo zonse zimakhala zabwino kwambiri kuposa odwala omwe ali ndi mtima wosalimba wa mtima, amachepetsedwabe. Ichi ndi chifukwa chake aliyense amene ali ndi vuto la mtima wosayenerera ayenera kuchitidwa nkhanza - poyesera kuthetsa zonse zomwe zikugwirizana ndi matendawa.
Kwa anthu amene apezeka ndi matenda oopsa a diastolic koma omwe alibe zizindikilo za mtima wosagonjetsa , umboni ukuwonjezeka kuti anthuwa ali ndi chiwerengero cha anthu omwe amamwalira kuposa onse. Kupeza izi sikuyenera kudabwitsa mukamaganizira zomwe zimayambitsa matenda a diastolic, mphamvu ya madokotala kuti "ayesetse" machitidwe awiriwa (mwachitsanzo, matenda oopsa kwambiri komanso matenda osokoneza bongo), komanso mavuto omwe anthu ambiri ali nawo kusintha moyo wamakhalidwe abwino, ndi kulemera.
Kulephera kwa diastolic ndi kofunika kwambiri kuti, makamaka, ayenera kufufuza mosamalitsa zifukwa zomwe zimayambitsa, ndiyeno nkhanza. Kuchiza koyenera kwa matenda osokoneza bongo kungachititse kuti pakhale zotsatira zabwino.
> Zotsatira:
> Borlaug BA, Paulus WJ. Mtima Woperewera ndi Zopopera Zopulumutsidwa: Kuteteza Pathophysiology, Kusanthula, ndi Chithandizo. Mtima; 32: 670.
> Pitt B, Pfeffer MA, Assmann SF, et al. Spironolactone kwa Mtima Yoperewera ndi Fraction Yopulumutsidwa. N Engl J Med 2014; 370: 1383.
> Yambani CW, Jessup M, Bozkurt B, et al. 2013 ACCF / AHA Malangizo Otsogolera Kulephera kwa Mtima: Lipoti la American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. J ndi Coll Cardiol 2013; 62: e147.