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EACVI Echo Handbook - sample

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Chapter 5 Assessment of

Chapter 5 Assessment of Diastolic Function 5.1 Left ventricle diastolic function 162 Principles and basic physiology 162 M-mode and 2D/3D echocardiography 164 PW Doppler echocardiography 165 Pulmonary venous flow 171 PW tissue Doppler echocardiography 175 Colour-flow M-mode Doppler 179 Echocardiographic assessment of LV diastolic function 181 Suggested reading 185 161

Chapter 5 Assessment of Diastolic Function Presence and severity of diastolic dysfunction (Table 5.1.13, Table 5.1.14, Figs. 5.1.23-25) Table 5.1.13 Presence and severity of diastolic dysfunction (STEP 1) Pathophysiology Normal Mild Mild–Moderate Moderate Severe relaxation ↓ relaxation ↓ LVFP ↑ relaxation↓ compliance↓ LVFP↑ relaxation ↓ compliance ↓↓ LVFP↑↑ E/A 1–2 < 1 < 1 1–2 > 2 e'/a' 1–2 < 1 < 1 < 1 > 1 IVRT (ms) 50–100 > 100 Normal ↓ ↓ DT (ms) 150–200 > 200 > 200 150–200 < 150 S/D ≥ 1 S > D S > D S < D S 20 > 20 > 20 Table 5.1.14 Estimation of LV filling pressure (STEP 2) LA E/A EDT Ar Ar dur S/D DDT E/e' E/Vp – A dur ↑ > 2 < 150 ms > 0.35 m/s > 30 ms S < D < 175 ms > 15 > 2 182

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