scholarly journals Assessment Of Left Ventricular Diastolic Function By Doppler Echocardiography

2015 ◽  
Vol 1 (2) ◽  
pp. 87 ◽  
Author(s):  
Michael Y Henein ◽  
Per Lindqvist ◽  
◽  
◽  
Keyword(s):  
Diastolic Function ◽  
Coronary Flow ◽  
Wall Motion ◽  
Cardiac Cycle ◽  
Myocardial Function ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Pulsed Wave Doppler ◽  
Late Diastole ◽  
Isovolumic Relaxation

Diastole is an essential part of the cardiac cycle, during which significant changes in myocardial function, ion and energy transfer, as well as coronary flow, occur. In contrast to systole, diastole consists of four phases, each of which has its distinguishing function and events. However, the four phases are inter-related with events in early diastole correlating with those in late diastole and those occurring during the isovolumic relaxation time predicting both. The complexity of diastolic phases is reflected in the ways by which diastolic function is assessed. While intra-cardiac flow velocities, into and out of the atria, are measured by pulsed-wave Doppler, those of wall motion are assessed by M-mode, myocardial Doppler velocities or, recently, speckle tracking technique. Optimum integration of various aspects of diastolic function should always be considered in order to obtain an accurate comprehensive assessment, bearing in mind factors that normally affect it, for example age.

Pulsed Doppler assessment of left ventricular diastolic function in normal and cardiomyopathic cats

1999 ◽  
Vol 35 (4) ◽  
pp. 285-291 ◽  
Author(s):  
JM Bright ◽  
ME Herrtage ◽  
JF Schneider
Keyword(s):  
Relaxation Time ◽  
Diastolic Function ◽  
Peak Velocity ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
P Value ◽  
Pulsed Doppler ◽  
Time Data ◽  
Isovolumic Relaxation Time ◽  
Isovolumic Relaxation

Left ventricular (LV) diastolic function was evaluated in 16 cats with primary hypertrophic cardiomyopathy (HCM) using pulsed Doppler (PD) assessment of transmitral flow and isovolumic relaxation time. Data obtained was compared to data from 12 healthy, adult, research cats. Compared to normal cats, the HCM group showed significantly (p value less than 0.05) reduced early LV inflow velocities (mean +/- standard error [SE], peak velocity of 0.70+/-0.04 m/s versus 0.54+/-0.04 m/s and integrated velocity of 0.48+/-0.08 m/s versus 0.37+/-0.03 m/s); a reduced rate of deceleration of early inflow (mean+/-SE, -12.0+/-1.0 m/s2 versus -5.1+/-1.1 m/s2); prolonged isovolumic relaxation time (mean +/- SE, 45.7+/-3.3 ms versus 76.0+/-3.1 ms); and increased atrial systolic flow velocities (mean +/- SE, peak velocity of 0.29+/-0.04 m/s versus 0.48+/-0.04 m/s and integrated velocity of 0.21+/-0.03 m/s versus 0.34+/-0.03 m/s). The results suggest that PD provides a noninvasive method of identifying and quantifying functional diastolic impairment in cats with HCM.

What global diastolic function is, what it is not, and how to measure it

2015 ◽  
Vol 309 (9) ◽  
pp. H1392-H1406 ◽  
Author(s):  
Charles S. Chung ◽  
Leonid Shmuylovich ◽  
Sándor J. Kovács
Keyword(s):  
Diastolic Function ◽  
Wall Motion ◽  
Heart Function ◽  
Left Ventricular ◽  
Global Perspective ◽  
Pressure Gradients ◽  
Elastic Recoil ◽  
Kinematic Models ◽  
Isovolumic Relaxation

Despite Leonardo da Vinci's observation (circa 1511) that “the atria or filling chambers contract together while the pumping chambers or ventricles are relaxing and vice versa,” the dynamics of four-chamber heart function, and of diastolic function (DF) in particular, are not generally appreciated. We view DF from a global perspective, while characterizing it in terms of causality and clinical relevance. Our models derive from the insight that global DF is ultimately a result of forces generated by elastic recoil, modulated by cross-bridge relaxation, and load. The interaction between recoil and relaxation results in physical wall motion that generates pressure gradients that drive fluid flow, while epicardial wall motion is constrained by the pericardial sac. Traditional DF indexes (τ, E/E′, etc.) are not derived from causal mechanisms and are interpreted as approximating either stiffness or relaxation, but not both, thereby limiting the accuracy of DF quantification. Our derived kinematic models of isovolumic relaxation and suction-initiated filling are extensively validated, quantify the balance between stiffness and relaxation, and provide novel mechanistic physiological insight. For example, causality-based modeling provides load-independent indexes of DF and reveals that both stiffness and relaxation modify traditional DF indexes. The method has revealed that the in vivo left ventricular equilibrium volume occurs at diastasis, predicted novel relationships between filling and wall motion, and quantified causal relationships between ventricular and atrial function. In summary, by using governing physiological principles as a guide, we define what global DF is, what it is not, and how to measure it.

scholarly journals Transesophageal Versus Transthoracic Echocardiography for Assessment of Left Ventricular Diastolic Function

2020 ◽  
pp. 1-8
Author(s):  
Carlos A. Roldan ◽  
Ihab B. Alomari ◽  
Khaled Awad ◽  
Carlos A. Roldan ◽  
Clifford R. Qualls ◽  
...  
Keyword(s):  
Relaxation Time ◽  
Diastolic Function ◽  
Transthoracic Echocardiography ◽  
Pulmonary Veins ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Ventricular Diastolic Function ◽  
Isovolumic Relaxation Time ◽  
Isovolumic Relaxation ◽  
Deceleration Time

Background: Transesophageal echocardiography (TEE) has not been compared to transthoracic echocardiography (TTE) for assessment of left ventricular diastolic function (LVDF). Left ventricular diastolic dysfunction is common in systemic lupus erythematosus (SLE), a disease model of premature myocardial disease. Methods: 66 patients with SLE (mean age 36±12 years, 91% women) and 26 age-and-sex matched healthy volunteers (mean age 34±11 years, 85% women) underwent TEE immediately followed by TTE. From basal four-chamber views, mitral inflow E and A velocities, E/A ratio, E deceleration time, isovolumic relaxation time, septal and lateral mitral E’ and A’ velocities, septal E’/A’ ratio, mitral E to septal and lateral E’ ratios, and pulmonary veins systolic to diastolic peak velocities ratio were measured. Measurements were averaged over 3 cardiac cycles and performed by 2 independent observers. Results: LVDF parameters were worse in patients than in controls by TEE and TTE (all p≤0.03). Most LVDF parameters were similar within each group by TEE and TTE (all p≥0.17). By both techniques, mitral E and A, mitral and septal E/A ratios, septal and lateral E’, septal and lateral E/E’ ratios, and average E/E’ ratio were highly correlated (r=0.64-0.96, all p≤0.003); E deceleration time, isovolumic relaxation time, and septal A’ velocities were moderately correlated (r=0.43-0.54, all p≤0.03); and pulmonary veins systolic to diastolic ratio showed the lowest correlation (r=0.27, p=0.04). Conclusion: By TEE and TTE, LVDF parameters were worse in SLE patients than in controls; and in both groups, LVDF parameters assessed by TEE and TTE were similar and significantly correlated.

The effects of caloric restriction- and exercise-induced weight loss on left ventricular diastolic function

2008 ◽  
Vol 294 (3) ◽  
pp. H1174-H1182 ◽  
Author(s):  
Matt M. Riordan ◽  
Edward P. Weiss ◽  
Timothy E. Meyer ◽  
Ali A. Ehsani ◽  
Susan B. Racette ◽  
...  
Keyword(s):  
Weight Loss ◽  
Diastolic Function ◽  
Caloric Restriction ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Tissue Imaging ◽  
Diastolic Filling ◽  
Exercise Induced ◽  
Prime 2 ◽  
Isovolumic Relaxation

Little is known about the effects of weight loss on diastolic function. Furthermore, it is not known whether both caloric restriction (CR)- and exercise (Ex)-induced weight loss have salutary effects on diastolic function. Therefore, we assessed the effects of yearlong CR ( n = 12) and Ex ( n = 13) interventions, which induced ∼12% weight loss, on diastolic function in healthy, nonobese (body mass index = 23.5–29.9 kg/m2) men and women aged 50 to 60 yr. Recordings of Doppler transmitral flow and Doppler tissue imaging were acquired and analyzed by conventional approaches and a validated parameterized diastolic filling (PDF) formalism. Isovolumic relaxation time decreased after weight loss in both groups ( P < 0.05). Septal peak early mitral annular velocity (E′) increased ( P < 0.01) and peak E-wave velocity/E′ decreased ( P < 0.05) after weight loss in the CR group. Based on the PDF-derived indexes, CR resulted in a decrease in global ventricular stiffness ( k) and increases in longitudinal (septal annulus motion) stored elastic strain ( x′o), peak force ( k′ x′o), and peak stored strain energy (1/2 k′ xoprime;2). In the Ex group, k was unchanged, although septal x′o and 1/2 k′ xo′2 increased significantly and k′ x′o ( P = 0.13) tended to increase. We conclude that weight loss, whether induced by CR or Ex, has salutary effects on diastolic function.

Coronary flow and left ventricular diastolic function in aortic regurgitation

1995 ◽  
Vol 6 (8) ◽  
pp. 635-644 ◽  
Author(s):  
Gloria Tamborini ◽  
Paolo Barbier ◽  
Elisabetta Doria ◽  
Franco Bortone ◽  
Erminio Sisillo ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Aortic Regurgitation ◽  
Coronary Flow ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Ventricular Diastolic Function
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