ECHO 2013 / Echo Assessment of Diastolic Function
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Doppler Tissue Echocardiography
Garcia et al, J Am Coll Cardiol 1996;27:108
JACC
Kasner, J Am Coll Cardiol 2011;57:977–85
Kasner, J Am Coll Cardiol 2011;57:977–85
LV Stiffness
Greater increase in LV pressure for a given increase in LV volume
LV Pressure
Pre-A LVP
LVEDP
LV volume
Normal |
“Mildly Stiff” “Severely Stiff” |
PV flow and LV Stiffness
Correlation of ARdur-Adur and LVEDP
Rossvol and Hatle, JACC 1993;21:1687
dv/dt MVA/(LA-LV Compliance)
DT
DT and LV Stiffness
Garcia, Am J Physiol 2001;280:H554
300
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y = 231.16e-1.7712x |
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250 |
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r = 0.87 |
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p < 0.001 |
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DT (msec) |
200 |
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150 |
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100 |
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50 |
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0 |
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0 |
0.1 |
0.2 |
0.3 |
0.4 |
0.5 |
0.6 |
KLV (mmHg/ml)
DT 11.6 Cn 
pmax
MVA
Circulation. 2011;124:2491-2501
Circulation 2011;124:2491-2501
Circulation 2011;124:2491-2501
Summary
•All patients with CHF have abnormal diastolic function
•Diastolic dysfunction correlates with symptoms and FC in SHF patients
•Suspect diastolic dysfunction if normal LV size, dilated LA, low E/E’ (>15)
•Consider Cardiac MRI to r/o specific treatable causes