Journal of Echocardiography

, Volume 8, Issue 3, pp 65–79 | Cite as

Diastology 2010: clinical approach to diastolic heart failure

Review Article


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.


Diastole Heart failure Echocardiography Tissue Doppler LV filling pressures Prognosis 



Heart failure


Left ventricle, left ventricular


Ejection fraction


Left atrial


Restrictive filling pattern


Peak early diastolic transmitral flow velocity


Atrial systolic transmitral flow velocity


Deceleration time of the early diastolic flow velocity wave


First systolic pulmonary venous flow velocity


Second systolic pulmonary venous flow velocity


Diastolic pulmonary venous flow velocity


Pulmonary venous flow velocity at mitral valve closure


Atrial reversal pulmonary venous flow velocity


Early diastolic mitral annular velocity


Atrial systolic mitral annular velocity


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


The slope of the flow propagation velocity


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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

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