A clinical approach to the assessment of left ventricular diastolic function by Doppler echocardiography: update 2003

• Published in: British heart journal 2003-11, Vol.89 (suppl 3), p.iii18-23
• Main Authors: Ommen, S R, Nishimura, R A
• Format: Article
• Language: English
• Subjects: Blood Flow Velocity - physiology; Diastole - physiology; Doppler echocardiography; Doppler effect; Echocardiography, Doppler - methods; Heart failure; Humans; left ventricular diastolic function; Mitral Valve - physiology; Pulmonary arteries; Pulmonary Circulation - physiology; Suctioning; Systole - physiology; Ultrasonic imaging; Velocity; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - physiopathology
• ISSN: 1355-6037; 0007-0769; 1468-201X
• DOI: 10.1136/heart.89.suppl_3.iii18

The initial abnormality of diastolic function is loss of the elastic recoil/suction forces in early diastole.\n The mitral inflow and mitral annulus velocity signals can be obtained in over 90% of patients. [...]these two Doppler parameters, in conjunction with the two dimensional echocardiographic findings, represent the most efficient means of initial diastolic assessment. In the intermediate group (E/e[variant prime] 8-15), abnormal filling pressure can be predicted only if other Doppler variables meet high specificity cut-off values. [...]a patient with intermediate E/e[variant prime] can be classified as raised filling pressure if the E/A ratio decreases by more the 0.5 during the Valsalva manoeuvre, or the pulmonary venous A wave duration exceeds the mitral a wave duration by at least 30 ms. If neither of these conditions is met and the left atrial size is normal, filling pressure is to be likely normal.