Diastolic function assessment by echocardiography: A practical manual for clinical use and future applications

Abstract

Diastole is an important component of the cardiac cycle, during which time optimum filling of the ventricle determines physiological stroke volume ejected in the succeeding systole. Many factors contribute to optimum ventricular filling including venous return, left atrial filling from the pulmonary circulation, and emptying into the left ventricle. Left ventricular filling is also impacted by the cavity emptying function and also its synchronous function which may suppress early diastolic filling in severe cases of dyssynchrony. Sub‐optimum LA emptying increases cavity pressure, causes enlarged left atrium, unstable myocardial function, and hence atrial arrhythmia, even atrial fibrillation. Patients with clear signs of raised left atrial pressure are usually symptomatic with exertional breathlessness. Doppler echocardiography is an ideal noninvasive investigation for diagnosing raised left atrial pressure as well as following treatment for heart failure. Spectral Doppler based increased E/A, shortened E‐wave deceleration time, increased E/e’, and prolonged atrial flow reversal in the pulmonary veins are all signs of raised left atrial pressure. Left atrial reduced myocardial strain is another correlate of raised cavity pressure (>15 mm Hg). In patients with inconclusive signs of raised left atrial pressure at rest, exercise/stress echocardiography or simply passive leg lifting should identify those with stiff left ventricular which suffers raised filling pressures with increased venous return.

AData‐DrivenAnalysis of Myocardial Tissue Contraction on Mild Transverse Aortic Constriction

“…This framework has the potential to contribute to the creation of new indices that combine physiological findings and the discriminative features used by a highly accurate model. Apart from EF, several echocardiographic parameters are used to measure the diastolic function of the left ventricle [31]. The correlation between these parameters and the ones extracted in this study must be examined in future studies.…”

Significance of the echocardiographic evaluation of left atrial myocardial strain for early diagnosis of heart failure with preserved ejection fraction

“…Многие факторы способствуют оптимальному наполнению ЛЖ, в том числе венозный возврат, приток крови из малого круга кровообращения в ЛП и его опорожнение в ЛЖ. Нарушение данного процесса увеличивает давление в полости ЛП, что приводит к его дилатации, а следовательно, и к дисфункции миокарда [29]. Помимо механических нарушений ЛП, его эндокринная дисфункция, выражающаяся в снижении синтеза предсердного натрийуретического пептида и / или развитии резистентности к нему, регуляторная недостаточность ЛП (симпатическая перегрузка, избыточный вазопрессин), а также его ремоделирование могут играть роль в реализации сложных патофизиологических механизмов, связанных с дисфункцией ЛП и СНсФВ [30].…”

Role of Echocardiography in Diabetic Cardiomyopathy: From Mechanisms to Clinical Practice

“…As previously stated, preload dependence is a factor because of which pseudo normal and normal patterns cannot be separated by transmittal inflow. At this stage, in order to more precisely assess DD, an additional analysis of Valsalva maneuver, myocardial velocities, pulmonary venous flow, and LA volume determination is necessary [ 53 ].…”