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Diastolic Stress Echocardiography

  • Chapter
Stress Echocardiography

Abstract

The increase of left ventricular (LV) filling pressure (LVFP) is the most important determinant of dyspnea (shortness of breath) and even of prognosis in patients with chronic heart failure, independent on the values of LV ejection fraction (EF) [1, 2]. The estimation of LVFP is traditionally obtained invasively by right cardiac catheterization which allows to measure pulmonary capillary wedge pressure (PCWP) as an indirect, though accurate, estimate of left atrial (LA) pressure [3, 4]. Nowadays, LVFP may be estimated in a completely noninvasive fashion by Doppler echocardiography. Current recommendations encourage the use of pulsed tissue Doppler for calculating the ratio between the preload-depending transmitral E velocity and the average of septal and lateral velocities of the earliest diastolic motion (e′) of the mitral annulus. This average velocity largely reflects the rate of myocardial relaxation, not depending on pressure flow gradients [5]. In addition to be very feasible and widely available, E/e′ ratio predicts outcome after acute myocardial infarction [6], in patients with heart failure [7] and arterial hypertension [8] and in those mechanically ventilated in intensive care unit [9]. E/e′ ratio can be also applied in clinical practice to drive medical therapy and titrate cardiac drugs in patients with chronic heart failure [10].

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Authors and Affiliations

  1. Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy

    Maurizio Galderisi MD

  2. CNR Pisa, Ist. Fisiologia Clinica, Via Moruzzi 1, Pisa, 56124, Italy

    Eugenio Picano MD, PhD

Authors
  1. Maurizio Galderisi MD
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  2. Eugenio Picano MD, PhD
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Galderisi, M., Picano, E. (2015). Diastolic Stress Echocardiography. In: Stress Echocardiography. Springer, Cham. https://doi.org/10.1007/978-3-319-20958-6_25

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  • DOI: https://doi.org/10.1007/978-3-319-20958-6_25

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-20957-9

  • Online ISBN: 978-3-319-20958-6

  • eBook Packages: MedicineMedicine (R0)

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