Current Cardiology Reports

, 21:109 | Cite as

Echocardiographic Diastolic Stress Testing: What Does It Add?

  • Kyung-Hee Kim
  • Garvan C. Kane
  • Christina L. Luong
  • Jae K. OhEmail author
Echocardiography (JM Gardin and AH Waller, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Echocardiography


Purpose of Review

Diastolic stress echocardiography may help facilitate the attribution of exertional dyspnea to cardiac and non-cardiac disease. It represents a non-invasive hemodynamic test to assess the patients with unexplained dyspnea. It can improve the diagnosis of heart failure with preserved ejection fraction (HFpEF) or diastolic heart failure.

Recent Findings

A number of studies have validated exercise E/e′ as a measure of left ventricular (LV) filling pressure against invasively measured LV filling pressure using simultaneous exercise echocardiography-catheterization studies. Addition of E/e′ during exercise echocardiography improved sensitivity for diagnosis of HFpEF compared with resting assessment alone, and its specificity can be improved if tricuspid regurgitation velocity also increases above the normal range with exercise. The independent prognostic value of exercise E/e′ has also been well delineated in a number of studies.


Diastolic stress exercise echocardiography should be considered for all patients with unexplained or exertional dyspnea and normal diastolic filling pressure or grade 1 diastolic dysfunction on resting echocardiography. Addition of diastolic assessment with exercise echocardiography improves the sensitivity of the test in patients with dyspnea and there are sufficient data to integrate diastolic exercise test into our clinical practice.


Echocardiography Stress test Diastolic dysfunction 


Compliance with Ethical Standards

Conflict of Interest

Kyung-Hee Kim, Garvan C. Kane, Christina L. Luong, and Jae K. Oh declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Kyung-Hee Kim
    • 1
    • 2
  • Garvan C. Kane
    • 1
  • Christina L. Luong
    • 1
  • Jae K. Oh
    • 1
    Email author
  1. 1.Department of Cardiovascular Medicine, Division of Cardiovascular UltrasoundMayo ClinicRochesterUSA
  2. 2.Division of Cardiovascular DiseaseSejong General HospitalBucheonSouth Korea

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