ECHO 2013 / Echocardiography For Assessment of Diastolic Function

E

A

E at A 0

Mdt

CP993639-19

Pseudonormalization

Valsalva LA pressure

+

Delayed LV relaxation

CP993639-28

Pseudonormalization

Valsalva LA pressure

+

Delayed LV relaxation

CP993639-29

Assessment of Diastolic Function

Positive Valsalva Response

•Caculate baseline E/A ratio*

•Calculate E/A ratio with Valsalva*

•Subtract Valsalva E/A from baseline E/A

•Positive response ≥ 0.5

*Correct for E at A velocity

Pseudonormalization

Doppler Clues (Increased filling pressure)

•Pulmonary vein

•Systolic velocity

•AR velocity

•Pulmonary vein AR-duration > mitral A-duration

CP1018119-4

PV AR Duration - MV A Duration

> 30 msec = Increased LVEDP

Accurate for patients with

•LVEF > 50%

•Hypertrophic cardiomyopathy

•Mitral valve disease