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Challenges for ‘diastology’: contributions from Japanese researchers

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Abstract

Diastology is a study to treat diastole of the heart. Transmitral flow and pulmonary venous flow velocities recorded by pulsed Doppler echocardiography provide more important information about left ventricular (LV) diastolic dysfunction [left atrial (LA)−LV coupling] than cardiac catheterization in clinical practice; however, these waveforms are influenced by loading conditions, particularly preload. The early diastolic mitral annular and LV wall motion indices measured by tissue Doppler echocardiography can evaluate LV relaxation abnormality and filling pressure by being relatively preload independent. In addition, the role of concomitant systolic longitudinal dysfunction is well characterized in asymptomatic patients and in patients with heart failure and preserved ejection fraction. Two-dimensional speckle tracking echocardiography is an angle-independent method, and has the potential to evaluate the contraction and relaxation abnormalities in the longitudinal, circumferential, and radial directions of the LV myocardium as well as LV torsion/untwisting and, moreover, deformation of the LA myocardium and large arterial wall. As a result, this new technique can facilitate the early detection of impaired LA−LV−arterial coupling in patients before occurrence of overt heart failure symptoms.

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Acknowledgments

We are grateful to cooperation and support of our colleagues in the echocardiography team at the Second Department of Internal Medicine, Tokushima University Faculty of Medicine, and Higashi Tokushima Medical Center, National Hospital Organization.

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Authors and Affiliations

  1. Cardiovascular Section, Higashi Tokushima Medical Center, National Hospital Organization, Tokushima, Japan

    Takashi Oki, Hirokazu Miyoshi, Yoshifumi Oishi, Yukio Mizuguchi & Arata Iuchi

  2. Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan

    Hirotsugu Yamada

  3. Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan

    Satoshi Nakatani

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  1. Takashi Oki
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  2. Hirokazu Miyoshi
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Oki, T., Miyoshi, H., Oishi, Y. et al. Challenges for ‘diastology’: contributions from Japanese researchers. J Echocardiogr 14, 93–103 (2016). https://doi.org/10.1007/s12574-016-0307-3

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