Progress in CardiologyDiastolic dysfunction: Improved understanding using emerging imaging techniques
Section snippets
Diagnosis by echocardiography
Measurement of LV pressure decline over time by cardiac catheterization is a useful parameter of impaired diastolic relaxation, but this has largely been replaced by echocardiography to assess diastolic function.7 Initial techniques, such as mitral valve inflow pulsed-wave Doppler, are dependent on loading conditions, systolic function, and heart rate; but recent methods are load independent and have improved assessment of diastolic dysfunction.8
Conclusion
The assessment of diastolic function is now essential on routine testing for HF. The noninvasive nature of echocardiography has allowed an increase in diagnosis and awareness of diastolic dysfunction, whereas or the unique features of CMRI allow for the detailed evaluation of diastolic dysfunction. Both modalities offer insights into the mechanism of diastolic dysfunction in HF with normal LVEF. The increased and rising prevalence of HF with normal LVEF, along with the absence of effective
Disclosure
No extramural funding was used to support this manuscript. The authors are solely responsible for the drafting and editing of the paper and its final contents.
References (57)
- et al.
Importance of heart failure with preserved systolic function in patients > or = 65 years of age
Am J Cardiol
(2001) - et al.
Prevalence, clinical features and prognosis of diastolic heart failure: an epidemiologic perspective
J Am Coll Cardiol
(1995) - et al.
The echo-Doppler evaluation of left ventricular diastolic function: a current perspective
Cardiol Clin
(2000) - et al.
Effects of age on left ventricular dimensions and filling dynamics in 117 normal persons
Mayo Clin Proc
(1994) Influence of incremental changes in heart rate on mitral flow velocity: assessment in lightly sedated, conscious dogs
J Am Coll Cardiol
(1991)- et al.
Utility of preload alteration in assessment of left ventricular filling pressure by Doppler echocardiography: a simultaneous catheterization and Doppler echocardiographic study
J Am Coll Cardiol
(1997) - et al.
Atrial contraction is an important determinant of pulmonary venous flow
J Am Coll Cardiol
(1986) - et al.
Determination of left ventricular filling pressure by Doppler echocardiography in patients with coronary artery disease: critical role of left ventricular systolic function
J Am Coll Cardiol
(1997) - et al.
Recommendations for the evaluation of left ventricular diastolic function by echocardiography
J Am Soc Echocardiogr
(2009) - et al.
Mitral regurgitation and left ventricular diastolic dysfunction similarly affect mitral and pulmonary vein flow Doppler parameters: the advantage of end diastolic markers
J Am Soc Echocardiogr
(2001)
Prognostic value of pulmonary venous flow Doppler signal in left ventricular dysfunction: contribution of the difference in duration of pulmonary venous and mitral flow at atrial contraction
J Am Coll Cardiol
An index of early left ventricular filling that combined with pulsed Doppler peak E velocity may estimate capillary wedge pressure
J Am Coll Cardiol
Impact of left ventricular ejection fraction on estimation of left ventricular filling pressures using tissue Doppler and flow propagation velocity
Am J Cardiol
Ratio of left ventricular peak E-wave velocity to flow propagation velocity assessed by color M-mode Doppler echocardiography in first myocardial infarction: prognostic and clinical implications
J Am Coll Cardiol
Striking effect of left ventricular systolic performance on propagation velocity of left ventricular early diastolic filling flow
J Am Soc Echocardiogr
Effects of age, gender, and left ventricular mass on septal mitral annulus velocity (E') and the ratio of transmitral early peak velocity to E' (E/E')
Am J Cardiol
Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging
J Am Coll Cardiol
Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications
J Am Soc Echocardiogr
A practical approach to the echocardiographic evaluation of diastolic function
J Am Soc Echocardiogr
Feasibility of tissue magnetic resonance imaging: a pilot study in comparison with tissue Doppler imaging and invasive measurement
J Am Coll Cardiol
Analysis of global systolic and diastolic left ventricular performance using volume-time curves by real-time three-dimensional echocardiography
J Am Soc Echocardiogr
Myocardial strain and torsion quantified by cardiovascular magnetic resonance tissue tagging: studies in normal and impaired left ventricular function
JACC
Twist mechanics of the left ventricle: principles and application
JACC Cardiovasc Imaging
Assessment of diastolic function by cardiovascular magnetic resonance
Am Heart J
Regional diastolic dysfunction in individuals with left ventricular hypertrophy measured by tagged magnetic resonance imaging—the Multi-Ethnic Study of Atherosclerosis (MESA)
Am Heart J
Comparison of magnetic resonance imaging versus Doppler echocardiography for the evaluation of left ventricular diastolic function in patients with cardiac amyloidosis
Am J Cardiol
Relationship of magnetic resonance imaging estimation of myocardial iron to left ventricular systolic and diastolic function in thalassemia
JACC Cardiovasc Imaging
Left ventricular untwisting is an important determinant of early diastolic function
JACC Cardiovasc Imaging
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