Advertisement

Echocardiographic Assessment of Diastolic Function

  • Carolyn Y. Ho
Part of the Contemporary Cardiology book series (CONCARD)

Abstract

Diastole is the portion of the cardiac cycle that spans from isovolumic ventricular relaxation to the Her exercise tolerance has been slowly declining completion of antegrade mitral flow. There are four distinct phases of diastole (Fig. 1): (1) isovolumetric ventricular relaxation: an active, adenosine triphosphate (ATP)-requiring process that occurs from end-systole until left ventricular pressure falls below left arterial pressure leading to mitral valve (MV) opening; (2) rapid early ventricular filling: blood flows from left atrium (LA) into the left ventricle (LV) during continued, active, then passive LV relaxation; (3) diastasis: active ventricular relaxation is completed and near equilibration of LA and LV pressures occurs with resultant slow LA filling from pulmonary venous (PV) flow; and (4) atrial systole: increased transmitral pressure gradient from atrial contraction results in acceleration of blood flow from LA to LV.

Keywords

Left Atrium Diastolic Dysfunction Diastolic Function Constrictive Pericarditis Mitral Inflow 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Suggested Reading

  1. 1.
    Appleton CP, Hatle LK, Popp RL. Relation of transmitral flow velocity patterns to left ventricular diastolic function: new insights from a combined hemodynamic and Doppler echocardio-graphic study. J Am Coll Cardiol 1988;12:426–440.PubMedGoogle Scholar
  2. 2.
    Appleton CP, Jensen JL, Hatle LK, Oh JK. Doppler evaluation of left and right ventricular diastolic function: a technical guide for obtaining optimal flow velocity recordings. J Am Soc Echocardiogr 1997;10:271–292.PubMedCrossRefGoogle Scholar
  3. 3.
    Cardim N, Oliveira AG, Longo S, et al. Doppler tissue imaging: regional myocardial function in hypertrophic cardiomyopathy and in athlete’s heart. J Am Soc Echocardiogr 2003;16:223–232.PubMedCrossRefGoogle Scholar
  4. 4.
    Cohen GI, Pietrolungo JF, Thomas JD, Klein AL. A practical guide to assessment of ventricular diastolic function using Doppler echocardiography. J Am Coll Cardiol 1996;27:1753–1760.PubMedCrossRefGoogle Scholar
  5. 5.
    Drazner MH, Hamilton MA, Fonarow G, Creaser J, Flavell C, Stevenson LW. Relationship between right and left-sided filling pressures in 1000 patients with advanced heart failure. J Heart Lung Transplant 1999;18:1126–1132.PubMedCrossRefGoogle Scholar
  6. 6.
    Farias CA, Rodriguez L, Garcia MJ, Sun JP, Klein AL, Thomas JD. Assessment of diastolic function by tissue Doppler echocardiography: comparison with standard transmitral and pulmonary venous flow. J Am Soc Echocardiogr 1999;12:609–617.PubMedCrossRefGoogle Scholar
  7. 7.
    Garcia MJ, Rodriguez L, Ares M, Griffin BP, Thomas JD, Klein AL. Differentiation of constrictive pericarditis from restrictive cardiomyopathy: assessment of left ventricular diastolic velocities in longitudinal axis by Doppler tissue imaging. J Am Coll Cardiol 1996;27:108–114.PubMedCrossRefGoogle Scholar
  8. 8.
    Garcia MJ, Thomas JD, Klein AL. New Doppler echocardiographic applications for the study of diastolic function. J Am Coll Cardiol 1998;32:865–875.PubMedCrossRefGoogle Scholar
  9. 9.
    Giannuzzi P, Imparato A, Temporelli PL, et al. Doppler-derived mitral deceleration time of early filling as a strong predictor of pulmonary capillary wedge pressure in postinfarction patients with left ventricular systolic dysfunction. J Am Coll Cardiol 1994;23:1630–1637.PubMedCrossRefGoogle Scholar
  10. 10.
    Nagueh SF, Middleton KJ, Kopelen HA, Zoghbi WA, Quinones MA. Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol 1997;30:1527–1533.PubMedCrossRefGoogle Scholar
  11. 11.
    Nagueh SF, Lakkis NM, Middleton KJ, Spencer WH, 3rd, Zoghbi WA, Quinones MA. Doppler estimation of left ventricular filling pressures in patients with hypertrophic cardiomyopathy. Circulation 1999;99:254–261.PubMedGoogle Scholar
  12. 12.
    Nishimura RA, Tajik AJ. Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinician’s Rosetta Stone. J Am Coll Cardiol 1997;30:8–18.PubMedCrossRefGoogle Scholar
  13. 13.
    Pinamonti B, Zecchin M, Di Lenarda A, Gregori D, Sinagra G, Camerini F. Persistence of restrictive left ventricular filling pattern in dilated cardiomyopathy: an ominous prognostic sign. J Am Coll Cardiol 1997;29:604–612.PubMedCrossRefGoogle Scholar
  14. 14.
    Rakowski H, Appleton C, Chan KL, et al. Canadian consensus recommendations for the measurement and reporting of diastolic dysfunction by echocardiography: from the Investigators of Consensus on Diastolic Dysfunction by Echocardiography. J Am Soc Echocardiogr 1996;9:736–760.PubMedCrossRefGoogle Scholar
  15. 15.
    Sohn DW, Chai IH, Lee DJ, et al. Assessment of mitral annulus velocity by Doppler tissue imaging in the evaluation of left ventricular diastolic function. J Am Coll Cardiol 1997;30:474–480.PubMedCrossRefGoogle Scholar
  16. 16.
    Yamada H, Oki T, Mishiro Y, Tabata T, et al. Effect of aging on diastolic left ventricular myocardial velocities measured by pulsed tissue Doppler imaging in healthy subjects. J Am Soc Echocardiogr 1999;12:574–581.PubMedCrossRefGoogle Scholar
  17. 17.
    Yamamoto K, Nishimura RA, Chaliki HP, Appleton CP, Holmes DR, Jr., Redfield MM. Determination of left ventricular filling pressure by Doppler echocardiography in patients with coronary artery disease: critical role of left ventricular systolic function. J Am Coll Cardiol 1997;30:1819–1826.PubMedCrossRefGoogle Scholar

Copyright information

© Humana Press Inc., Totowa, NJ 2007

Authors and Affiliations

  • Carolyn Y. Ho
    • 1
  1. 1.Cardiovascular Genetics Center, Cardiovascular Division, Brigham and Women’s HospitalHarvard Medical SchoolBoston

Personalised recommendations