Journal of Echocardiography

, Volume 8, Issue 3, pp 65–79

Diastology 2010: clinical approach to diastolic heart failure

Review Article

DOI: 10.1007/s12574-010-0055-8

Cite this article as:
Yamada, H. & Klein, A.L. J Echocardiogr (2010) 8: 65. doi:10.1007/s12574-010-0055-8

Abstract

The role of echocardiography in the evaluation of left ventricular diastolic function is increasingly important in both systolic and diastolic heart failure. In routine clinical practice, the diastolic dysfunction associated with diastolic heart failure can mainly be evaluated by Doppler echocardiography. In order to use echocardiographic techniques for this purpose, one should recognize the definition, terminology, epidemiology, and pathophysiology of diastolic dysfunction and diastolic heart failure. There are various echocardiographic parameters for this purpose, including transmitral flow velocity, pulmonary venous flow velocity, mitral annular velocity, flow propagation velocity, left atrial size, strain, strain rate, twist, and so on. However, no single Doppler echocardiographic index has yielded a robust criterion for diastolic dysfunction and elevated left ventricular filling pressure. Thus, multiple indices are required to increase the sensitivity of the diagnosis. Clinicians who take care of heart failure patients should continue to make critical use of a current Doppler echocardiographic evaluation and utilize this information to improve survival and quality of life in these patients.

Keywords

DiastoleHeart failureEchocardiographyTissue DopplerLV filling pressuresPrognosis

Abbreviations

HF

Heart failure

LV

Left ventricle, left ventricular

EF

Ejection fraction

LA

Left atrial

RFP

Restrictive filling pattern

E

Peak early diastolic transmitral flow velocity

A

Atrial systolic transmitral flow velocity

DT

Deceleration time of the early diastolic flow velocity wave

PVS1

First systolic pulmonary venous flow velocity

PVS2

Second systolic pulmonary venous flow velocity

PVD

Diastolic pulmonary venous flow velocity

PVC

Pulmonary venous flow velocity at mitral valve closure

AR

Atrial reversal pulmonary venous flow velocity

e′

Early diastolic mitral annular velocity

a′

Atrial systolic mitral annular velocity

TE-e′

Time interval between the onset of the early diastolic transmitral flow velocity and that of the early diastolic mitral annular velocity

Vp

The slope of the flow propagation velocity

Copyright information

© Japanese Society of Echocardiography 2010

Authors and Affiliations

  1. 1.Department of Cardiovascular Medicine, Institute of Health Bioscience ResearchThe University of Tokushima Graduate School of MedicineTokushimaJapan
  2. 2.Department of Cardiovascular Imaging, Heart and Vascular InstituteCleveland ClinicClevelandUSA