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CSI 2021:How to Assess LV Diastolic Function?

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Prof (Dr) Pranab Jyoti Bhattacharyya, Guwahati     27 December 2021

  • Assessment of diastolic function is complex.
  • An ‘‘impaired relaxation’’ pattern of LV filling needs to be interpreted in the context of other echo and clinical variables.
  • Normal vs. pseudonormal LV filling patterns is clinically important and needs to be differentiated.
  • In patients with preserved systolic function, measurement of transmitral flow in combination with mitral annular tissue Doppler velocities provide the most efficient means of assessing LV diastolic function and filling pressures. In patients with systolic dysfunction, diastolic Doppler parameters are principally used to determine LV filling pressures.
  • Left atrial (LA) volume is the “glycosylated hemoglobin” of diastolic dysfunction and reflects its chronicity, whereas the mitral inflow velocity patterns reflect instantaneous changes in filling pressure.
  • An entirely normal LA volume can exclude clinically important diastolic dysfunction. A normal-appearing mitral inflow velocity pattern usually represents a pseudonormal pattern if LA volume is increased

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