Evolving focus on diastolic dysfunction in patients with coronary artery disease

Purpose of review The purpose of this review is to summarize recent studies of coronary artery disease (CAD) and diastolic dysfunction. Recent findings Myocardial ischemia slows ventricular relaxation and can impair ventricular distensibility resulting in diastolic dysfunction apparent as abnormal left ventricular (LV) filling dynamics that can be recognized noninvasively. As such, the development of diastolic dysfunction during stress testing may improve the recognition of CAD. The noninvasive recognition of diastolic dysfunction indicates a poor prognosis in patients with an acute coronary syndrome and chronic CAD. Patients with heart failure with preserved ejection fraction (HFpEF) frequently have CAD, and it may contribute to the heart failure. Summary Myocardial ischemia produces diastolic dysfunction. The evaluation of diastolic dysfunction has diagnostic and prognostic roles in the management of CAD. CAD is a frequent and important comorbidity of HFpEF.