Global Strain Rate (SRivr) Wang et al Global Diastolic SR for LV Relaxation Circ. 2007; 115:1376-1383.
LA Volume Barometer of the chronicity of diastolic dysfunction. LA volume correlates with risk of cardiovascular events including MI, CVA, A fib and CHF. More stable than LV filling pressures. Douglas PS. The left atrium: a biomarker of chronic diastolic dysfunction and cardiovascular disease risk. JACC 2002;42:1206-7.
Objectives Defining Diastole Diastolic Function Measurements Diastolic Function Grades
BIDMC Echo Lab Decel Time 140-250ms E/e’: <8 normal E/e’>15 (LVEDP>18mmHg)
Approach to the Patient
Summary Diastole is a complex, energy dependent process. Echo indices of diastolic fn include: –Transmitral Doppler inflow –Tissue Doppler velocities –Pulmonary venous Doppler flow –Color M-mode propagation velocity Diastolic dysfunction is a measurable, step-wise progression from normal to irreversible.
References Otto CM. Textbook of clinical echocardiography, 4 th Edition. Douglas PS. The left atrium: a biomarker of chronic diastolic dysfunction and relation to cardiovascular risk burden. JACC 2002;40:1206-7. http://www.echobasics.de/diastole-en.html Lester SJ, Tajik AJ, Nishimura RA, et al. Unlocking the mysteries of diastolic function. JACC 2008;51:679-89. Nagueh SF, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J Am S Echo 2009;22:107-33 Nishimura RA, Tajik AJ. Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinician’s Rosetta Stone. JACC 1997;30:8-18. Ommen SR, Nishimura RA, Appleton CP, et al. Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: a comparative simultaneous Doppler- catheterization study. Circ. 2000;102:1788-94. Wang J, Khoury DS, Thohan V, Torre-Amione G, Nagueh SF. Global diastolic strain rate for the assessment of left ventricular relaxation and filling pressures. Circ. 2007;115:1376-83.