The literature of acquired heart disease is replete with references to diastolic dysfunction, most particularly as it applies to the left ventricle in an aging patient population.<sup>5 Cullen S., Shore D., Redington A. Characterization of right ventricular diastolic performance after complete repair of tetralogy of Fallot Circulation 1995 ;  91 : 1782-1789

Haga clic aquí para ir a la sección de Referencias, 21 Nishimura R.A., Tajik A.J. Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinician's rosetta stone J Am Coll Cardiol 1997 ;  30 : 8-18

Haga clic aquí para ir a la sección de Referencias, 24 Pearson A.C., Gudipati C.V., Labovitz A.J. , y al. Effect of aging on left ventricular structure and function Am Heart J 1991 ;  121 : 871-875  [cross-ref]

Haga clic aquí para ir a la sección de Referencias</sup> Assessment of diastolic function in the population of patients with congenital heart disease (CHD) must be applied not only to the left ventricle but to the right `single' ventricle as well. To review the influence of diastolic dysfunction in every known congenital heart defect, however, would be repetitive and speculative, as many patients with CHD have a multiplicity of defects, and the published data on diastology in this group are scarce.

There are several anatomic abnormalities leading to outflow obstruction (i.e., the various forms of aortic stenosis and coarctation of the aorta), which have correlates in acquired heart disease. Understanding the nature of diastolic dysfunction in this subgroup of patients with CHD initially was derived from extrapolation of data accumulated from patients with acquired heart disease but eventually was supported by direct assessment of the afflicted population. With complex surgical repair now the rule rather than the exception for patients with CHD, it has been recognized that satisfactory surgical outcome is not dependent solely on systolic function. Tetralogy of Fallot (TOF), because of its prevalence, whether operated or unoperated, and the various anatomic permutations of functionally “univentricular” hearts for which the ultimate common pathway of palliation is the Fontan procedure deserve inclusion in a review of diastolic dysfunction in CHD. Right ventricular diastolic physiology after TOF repair has been studied extensively, and the importance of evaluating diastolic function in the pre-Fontan candidate must be emphasized because of the well-recognized influence for both groups on postsurgical outcome. Genetically influenced alterations in the myocardium, as seen with the hypertrophic cardiomyopathies and congenital myotonic dystrophy, can alter the function of the heart in diastole and are therefore included in this article. The multiple factors that can influence diastolic function are outlined in Box 1.