How to Assess Diastolic Dysfunction?

Size: px
Start display at page:

Download "How to Assess Diastolic Dysfunction?"

Transcription

1 How to Assess Diastolic Dysfunction? Fausto J Pinto, MD, PhD, FESC, FACC, FASE Lisbon University

2

3

4 Dyastolic Dysfunction Impaired relaxation Elevated filling pressures Ischemic heart disease Cardiomyopathies Systemic disease Hypertension Valvular heart disease

5 Extracellular matrix and cardiomyocytes determine myocardial stiffness and interact via matricellular proteins. Borlaug B A, Paulus W J Eur Heart J 2010;eurheartj.ehq426

6 How to Assess Diastolic Function and LV filling pressures M-Mode (b bump) 2D Echo Doppler MV flow Pulmonary venous flow Color M Mode Altered loading conditions Tissue Doppler imaging

7 Diastolic Filling

8 How to assess diastolic function: What to Measure?

9 MV velocities and time intervals

10

11 Filling Patterns

12 PW Doppler of mitral inflow velocities from predominant relaxation abnormality (left), normal or pseudonormal (center), and restrictive (right) filling patterns Oh, J. K. et al. J Am Coll Cardiol 2006;47:

13 Prognostic value of mitral inflow restrictive pattern Bruch, C. et al. J Am Coll Cardiol 2005;45:

14 Limitations Heart rate PR interval Arrhythmias AV conduction abnl Technical problems in recording

15 Influence of heart rate

16 Where to put the sample?

17

18 Load dependence of the LV filling pattern. (A) Restrictive filling associated with increased preload in a patient with renal failure. (B) Following dialysis, removal of intravascular volume has reduced LV filling pressure and unmasked the underlying impaired relaxation pattern. The presence of "reversibility" of the restrictive filling pattern indicates less severe LV stiffening and is associated with a better prognosis. Mottram, P. M et al. Heart 2005;91:

19 MV flow dependent factors Rate and extent of ventricular relaxation Suction Atrial and ventricular compliance Mitral valve inertance LA pressure

20 Diastolic function curve Garcia et al. JACC 1998

21 Pseudonormalization pattern Dilated cardiomyopathy LAP 32 mm Hg Tau 68 ms Nishimura, Tajik JACC 1997;30:8

22 Valsalva Maneuver Change in E/A ratio with a reduction >0.5

23 Pulmonary Venous flow Velocities Oh J et al. Jam Soc Echocardiogr 1997;10:246

24 Normal Pseudonormal

25 Relaxation/Compliance abnl

26 Impact of Age

27 Color M Mode Flow propagation

28 Color M Mode Flow propagation

29 Longitudinal velocity Systole Diastole IVC Peak Systole Diastasis IVR E Diastolic Filling Phase A IVC IVR Isovolumic contraction time Isovumic relaxation time

30 Normal vs pseudonormal patterns

31 Restriction vs Constriction

32 Restriction vs Constriction Ha JW et al. Am J Cardiol 2004;94:316

33 Estimation of LV filling pressures Ommen SR et al Circulation 2000;102:1788

34

35 Estimation of LV filling pressures How to do it practically? E/E <8 Normal E/E > 15 Elevated 15<E/E >8 look at Pva 30 ms longer than Mva E/A reduction >0.5 with Valsalva LA size (LAV index>26 mm 2 )

36 Assessing Filling Pressure Post-AMI Hillis GS JACC 2004

37 Assessing Filling Pressure Post-AMI Hillis GS JACC 2004

38 Assessing Filling Pressure Post-AMI Hillis GS JACC 2004

39 Hemodynamic and Doppler traces of a patient with normal left ventricular diastolic pressure (LVDP) at rest (A) and an increase in LVDP with exercise (B) Burgess, M. I. et al. J Am Coll Cardiol 2006;47:

40 (A) Changes in the ratio of early diastolic transmitral velocity to early diastolic tissue velocity (E/E') between rest and exercise in patients with normal mean left ventricular diastolic pressure (LVDP) at both rest and exercise Burgess, M. I. et al. J Am Coll Cardiol 2006;47:

41 Relation between mitral E/Ea ratio and PCWP at baseline (top) and relation between changes (baseline to follow-up) in mitral E/Ea ratio and changes (baseline to follow-up) in PCWP (bottom) Mullens, W. et al. Circulation 2009;119:62-70

42 Limitations of e/e Tachycardia Hyperventilation Fusion of early and late trans mitral velocities Acute decompensated systolic heart failure (HFrEF)

43 Relationships between severity of diastolic dysfunction (DD) (left) and left atrial (LA) volume index (right) and survival Pritchett, A. M. et al. J Am Coll Cardiol 2005;45:87-92

44 LA volume and diastolic dysfunction Pritchett, A. M. et al. J Am Coll Cardiol 2005;45:87-92

45 Predictors of all cause mortality Pritchett, A. M. et al. J Am Coll Cardiol 2005;45:87-92

46

47 Diagnostic flowchart on How to diagnose HFNEF' in a patient suspected of HFNEF Paulus, W. J. et al. Eur Heart J 2007

48 Assessing Diastolic Function Extensive study (no magic numbers...) Evaluate relaxation/filling pressures Determine etiology/staging/prognosis Evaluate therapy

Left ventricular diastolic function and filling pressure in patients with dilated cardiomyopathy

Left ventricular diastolic function and filling pressure in patients with dilated cardiomyopathy Left ventricular diastolic function and filling pressure in patients with dilated cardiomyopathy Bogdan A. Popescu University of Medicine and Pharmacy Bucharest, Romania My conflicts of interest: I have

More information

An Integrated Approach to Study LV Diastolic Function

An Integrated Approach to Study LV Diastolic Function An Integrated Approach to Study LV Diastolic Function Assoc. Prof. Adriana Ilieşiu, FESC University of Medicine Carol Davila Bucharest, Romania LV Diastolic Dysfunction impaired relaxation (early diastole)

More information

Evalua&on)of)Le-)Ventricular)Diastolic) Dysfunc&on)by)Echocardiography:) Role)of)Ejec&on)Frac&on)

Evalua&on)of)Le-)Ventricular)Diastolic) Dysfunc&on)by)Echocardiography:) Role)of)Ejec&on)Frac&on) Evalua&on)of)Le-)Ventricular)Diastolic) Dysfunc&on)by)Echocardiography:) Role)of)Ejec&on)Frac&on) N.Koutsogiannis) Department)of)Cardiology) University)Hospital)of)Patras)! I have no conflicts of interest

More information

Diastolic Heart Failure

Diastolic Heart Failure Chronic Heart Failure Prevalence overall = 2-3 % Diastolic Heart Failure Patrick Wouters University Hospital Ghent Belgium (Heart Failure + Asymptomatic Ventricular Dysfunction) Prevalence > 70 y = 10-20

More information

Diastology State of The Art Assessment

Diastology State of The Art Assessment Diastology State of The Art Assessment Dr. Mohammad AlGhamdi Assistant professor, KSAU-HS Consultant Cardiologist King AbdulAziz Cardiac Center Ministry of National Guard Health Affairs Diagnostic Clinical

More information

E/Ea is NOT an essential estimator of LV filling pressures

E/Ea is NOT an essential estimator of LV filling pressures Euroecho Kopenhagen Echo in Resynchronization in 2010 E/Ea is NOT an essential estimator of LV filling pressures Wilfried Mullens, MD, PhD December 10, 2010 Ziekenhuis Oost Limburg Genk University Hasselt

More information

Μαρία Μπόνου Διευθύντρια ΕΣΥ, ΓΝΑ Λαϊκό

Μαρία Μπόνου Διευθύντρια ΕΣΥ, ΓΝΑ Λαϊκό Μαρία Μπόνου Διευθύντρια ΕΣΥ, ΓΝΑ Λαϊκό Diastolic HF DD: Diastolic Dysfunction DHF: Diastolic HF HFpEF: HF with preserved EF DD Pathophysiologic condition: impaired relaxation, LV compliance, LV filling

More information

Diastology Disclosures: None. Dias2011:1

Diastology Disclosures: None. Dias2011:1 Diastology 2011 James D. Thomas, M.D., F.A.C.C. Cardiovascular Imaging Center Department of Cardiology Cleveland Clinic Foundation Cleveland, Ohio, USA Disclosures: None Dias2011:1 Is EVERYBODY a member!?!

More information

The Patient with Atrial Fibrilation

The Patient with Atrial Fibrilation Assessment of Diastolic Function The Patient with Atrial Fibrilation Assoc. Prof. Adriana Ilieşiu, FESC University of Medicine Carol Davila Bucharest, Romania Associated Conditions with Atrial Fibrillation

More information

Diastolic Function Overview

Diastolic Function Overview Diastolic Function Overview Richard Palma BS, RDCS, RCS, APS, FASE Director and Clinical Coordinator The Hoffman Heart and Vascular Institute School of Cardiac Ultrasound None Disclosures Learning Objectives

More information

Diastole is Not a Single Entity Four Components of Diastolic Dysfunction

Diastole is Not a Single Entity Four Components of Diastolic Dysfunction Physiology of Diastolic Function Made Easy James D. Thomas, MD, FACC, FASE Director, Center for Heart Valve Disease Bluhm Cardiovascular Institute Professor of Medicine, Feinberg School of Medicine, Northwestern

More information

HFNEF. Heart Failure is

HFNEF. Heart Failure is HFNEF Bijoy K. Khandheria, MD. FASE, FACP, FACC FESC Professor of Medicine University of Wisconsin Director. Echocardiography Services Aurora Health Care No conflicts or off label use CP1173868-1 Heart

More information

Diastolic Function Assessment Practical Ways to Incorporate into Every Echo

Diastolic Function Assessment Practical Ways to Incorporate into Every Echo Diastolic Function Assessment Practical Ways to Incorporate into Every Echo Jae K. Oh, MD Echo Hawaii 2018 2018 MFMER 3712003-1 Learning Objectives My presentation will help you to Appreciate the importance

More information

Diastolic Function: What the Sonographer Needs to Know. Echocardiographic Assessment of Diastolic Function: Basic Concepts 2/8/2012

Diastolic Function: What the Sonographer Needs to Know. Echocardiographic Assessment of Diastolic Function: Basic Concepts 2/8/2012 Diastolic Function: What the Sonographer Needs to Know Pat Bailey, RDCS, FASE Technical Director Beaumont Health System Echocardiographic Assessment of Diastolic Function: Basic Concepts Practical Hints

More information

LA Function analysis Marcia Barbosa Vice Presidente - Brazilian Soc of Cardiology President-elect - Interamerican Soc of Cardiology

LA Function analysis Marcia Barbosa Vice Presidente - Brazilian Soc of Cardiology President-elect - Interamerican Soc of Cardiology LA Function analysis Marcia Barbosa Vice Presidente - Brazilian Soc of Cardiology President-elect - Interamerican Soc of Cardiology Belo Horizonte Brazil DECLARATION OF CONFLICT OF INTEREST Nothing to

More information

New aspects of Echocardiography in Hypertensive Heart Disease. Fausto J. Pinto, MD, PhD, FESC, FACC, FASE

New aspects of Echocardiography in Hypertensive Heart Disease. Fausto J. Pinto, MD, PhD, FESC, FACC, FASE New aspects of Echocardiography in Hypertensive Heart Disease Fausto J. Pinto, MD, PhD, FESC, FACC, FASE Progressive increase in cardiovascular morbidity (left) and all-cause mortality (right) rates

More information

Basic Approach to the Echocardiographic Evaluation of Ventricular Diastolic Function

Basic Approach to the Echocardiographic Evaluation of Ventricular Diastolic Function Basic Approach to the Echocardiographic Evaluation of Ventricular Diastolic Function J A F E R A L I, M D U N I V E R S I T Y H O S P I T A L S C A S E M E D I C A L C E N T E R S T A F F C A R D I O T

More information

Objectives. Diastology: What the Radiologist Needs to Know. LV Diastolic Function: Introduction. LV Diastolic Function: Introduction

Objectives. Diastology: What the Radiologist Needs to Know. LV Diastolic Function: Introduction. LV Diastolic Function: Introduction Objectives Diastology: What the Radiologist Needs to Know. Jacobo Kirsch, MD Cardiopulmonary Imaging, Section Head Division of Radiology Cleveland Clinic Florida Weston, FL To review the physiology and

More information

Diastolic Function Assessment New Guideline Update Practical Approach

Diastolic Function Assessment New Guideline Update Practical Approach Mayo Clinic Department of Cardiovascular Diseases Mayo Clinic Echocardiography Review Course for Boards and Recertification Diastolic Function Assessment New Guideline Update Practical Approach Jae K.

More information

Diastolic Functions: Evaluation & Clinical Applications

Diastolic Functions: Evaluation & Clinical Applications Special Articles Diastolic Functions: Evaluation & Clinical Applications Senior Consultant Cardiologist, Metro Heart Institute, Delhi Immediate Past President, Cardiological Society of India (Cardiovasc.

More information

The importance of left atrium in LV diastolic function

The importance of left atrium in LV diastolic function II Baltic Heart Failure Meeting and Congress of Latvian Society of Cardiology The importance of left atrium in LV diastolic function Dr. Artem Kalinin Eastern Clinical University Hospital Riga 30.09.2010.

More information

OPTIMIZING ECHO ACQUISTION FOR STRAIN AND DIASTOLOGY

OPTIMIZING ECHO ACQUISTION FOR STRAIN AND DIASTOLOGY OPTIMIZING ECHO ACQUISTION FOR STRAIN AND DIASTOLOGY October 8, 2017 Deborah Agler, ACS, RDCS, FASE Coordinator of Education and Training Cleveland Clinic General Principles Diastology Clinical Data Heart

More information

THE DIASTOLIC STRESS TEST: A NEW CLINICAL TOOL? THE CONCEPT OF DIASTOLIC RESERVE

THE DIASTOLIC STRESS TEST: A NEW CLINICAL TOOL? THE CONCEPT OF DIASTOLIC RESERVE Thierry C. Gillebert University of Ghent ESC Education Committee THE DIASTOLIC STRESS TEST: A NEW CLINICAL TOOL? THE CONCEPT OF DIASTOLIC RESERVE 1 Case: Ann, 63 years Suffered from metabolic syndrome

More information

P atients with heart disease frequently have abnormalities

P atients with heart disease frequently have abnormalities iii18 A clinical approach to the assessment of left ventricular diastolic function by Doppler echocardiography: update 2003 S R Ommen, R A Nishimura... P atients with heart disease frequently have abnormalities

More information

Echo Doppler Assessment of Right and Left Ventricular Hemodynamics.

Echo Doppler Assessment of Right and Left Ventricular Hemodynamics. Echo Doppler Assessment of Right and Left Ventricular Hemodynamics. Itzhak Kronzon, MD, FASE, FACC, FESC, FAHA, FACP, FCCP Northwell, Lenox Hill Hospital, New York Professor of Cardiology Hofstra University

More information

HFpEF. April 26, 2018

HFpEF. April 26, 2018 HFpEF April 26, 2018 (J Am Coll Cardiol 2017;70:2476 86) HFpEF 50% or more (40-71%) of patients with CHF have preserved LV systolic function. HFpEF is an increasingly frequent hospital discharge. Outcomes

More information

Effect of Heart Rate on Tissue Doppler Measures of E/E

Effect of Heart Rate on Tissue Doppler Measures of E/E Cardiology Department of Bangkok Metropolitan Administration Medical College and Vajira Hospital, Bangkok, Thailand Abstract Background: Our aim was to study the independent effect of heart rate (HR) on

More information

DOPPLER HEMODYNAMICS (1) QUANTIFICATION OF PRESSURE GRADIENTS and INTRACARDIAC PRESSURES

DOPPLER HEMODYNAMICS (1) QUANTIFICATION OF PRESSURE GRADIENTS and INTRACARDIAC PRESSURES THORAXCENTRE DOPPLER HEMODYNAMICS (1) QUANTIFICATION OF PRESSURE GRADIENTS and INTRACARDIAC PRESSURES J. Roelandt DOPPLER HEMODYNAMICS Intracardiac pressures and pressure gradients Volumetric measurement

More information

Heart Failure in Women: Dr Goh Ping Ping Cardiologist Asian Heart & Vascular Centre

Heart Failure in Women: Dr Goh Ping Ping Cardiologist Asian Heart & Vascular Centre Heart Failure in Women: More than EF? Dr Goh Ping Ping Cardiologist Asian Heart & Vascular Centre Overview Review pathophysiology as it relates to diagnosis and management Rational approach to workup:

More information

NEW GUIDELINES. A Guideline Protocol for the Echocardiographic assessment of Diastolic Dysfunction

NEW GUIDELINES. A Guideline Protocol for the Echocardiographic assessment of Diastolic Dysfunction NEW GUIDELINES A Guideline Protocol for the Echocardiographic assessment of Diastolic Dysfunction Echocardiography plays a central role in the non-invasive evaluation of diastole and should be interpreted

More information

Prognostic Value of Left Atrial Size and Function

Prognostic Value of Left Atrial Size and Function Prognostic Value of Left Atrial Size and Function James D. Thomas, M.D., F.A.C.C. Cardiovascular Imaging Center Department of Cardiology Cleveland Clinic Foundation Cleveland, Ohio, USA Conflicts: None

More information

Echo-Doppler evaluation of left ventricular diastolic function. Michel Slama Amiens France

Echo-Doppler evaluation of left ventricular diastolic function. Michel Slama Amiens France Echo-Doppler evaluation of left ventricular diastolic function Michel Slama Amiens France Left ventricular pressure Pressure A wave [ LVEDP LVEDP préa Congestive cardiac failure with preserved systolic

More information

LV geometric and functional changes in VHD: How to assess? Mi-Seung Shin M.D., Ph.D. Gachon University Gil Hospital

LV geometric and functional changes in VHD: How to assess? Mi-Seung Shin M.D., Ph.D. Gachon University Gil Hospital LV geometric and functional changes in VHD: How to assess? Mi-Seung Shin M.D., Ph.D. Gachon University Gil Hospital LV inflow across MV LV LV outflow across AV LV LV geometric changes Pressure overload

More information

GENERAL PRINCIPLES FOR ECHO ASSESSMENT OF DIASTOLIC FUNCTION (For full recommendation refer to the Left Ventricular Diastolic Function Guideline)

GENERAL PRINCIPLES FOR ECHO ASSESSMENT OF DIASTOLIC FUNCTION (For full recommendation refer to the Left Ventricular Diastolic Function Guideline) 1 THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY RECOMMENDATIONS FOR THE EVALUATION OF LEFT VENTRICULAR DIASTOLIC FUNCTION BY ECHOCARDIOGRAPHY: A QUICK REFERENCE GUIDE FROM THE ASE WORKFLOW AND LAB MANAGEMENT

More information

Imaging in Heart Failure: A Multimodality Approach. Thomas Ryan, MD

Imaging in Heart Failure: A Multimodality Approach. Thomas Ryan, MD Imaging in Heart Failure: A Multimodality Approach Thomas Ryan, MD Heart Failure HFrEF HFpEF EF50% Lifetime risk 20% Prevalence 6M Americans Societal costs - $30B 50% 5-year survival 1 Systolic

More information

LV FUNCTION ASSESSMENT: WHAT IS BEYOND EJECTION FRACTION

LV FUNCTION ASSESSMENT: WHAT IS BEYOND EJECTION FRACTION LV FUNCTION ASSESSMENT: WHAT IS BEYOND EJECTION FRACTION Jamilah S AlRahimi Assistant Professor, KSU-HS Consultant Noninvasive Cardiology KFCC, MNGHA-WR Introduction LV function assessment in Heart Failure:

More information

Adel Hasanin Ahmed 1

Adel Hasanin Ahmed 1 Adel Hasanin Ahmed 1 PERICARDIAL DISEASE The pericardial effusion ends anteriorly to the descending aorta and is best visualised in the PLAX. PSAX is actually very useful sometimes for looking at posterior

More information

P = 4V 2. IVC Dimensions 10/20/2014. Comprehensive Hemodynamic Evaluation by Doppler Echocardiography. The Simplified Bernoulli Equation

P = 4V 2. IVC Dimensions 10/20/2014. Comprehensive Hemodynamic Evaluation by Doppler Echocardiography. The Simplified Bernoulli Equation Comprehensive Hemodynamic Evaluation by Doppler Echocardiography Itzhak Kronzon, MD North Shore LIJ/ Lenox Hill Hospital New York, NY Disclosure: Philips Healthcare St. Jude Medical The Simplified Bernoulli

More information

Echo in Pulmonary HTN

Echo in Pulmonary HTN Echo in Pulmonary HTN Steven A. Goldstein MD FACC FASE Professor of Medicine Georgetown University Medical Center MedStar Heart Institute Washington Hospital Center Monday, October 10, 2017 Pulmonary Artery

More information

Comprehensive Hemodynamics By Doppler Echocardiography. The Echocardiographic Swan-Ganz Catheter.

Comprehensive Hemodynamics By Doppler Echocardiography. The Echocardiographic Swan-Ganz Catheter. Comprehensive Hemodynamics By Doppler Echocardiography. The Echocardiographic Swan-Ganz Catheter. Itzhak Kronzon, MD, FASE, FACC, FESC, FAHA, FACP, FCCP North Shore HS, LIJ/Lenox Hill Hospital, New York

More information

Choose the grading of diastolic function in 82 yo woman

Choose the grading of diastolic function in 82 yo woman Question #1 Choose the grading of diastolic function in 82 yo woman E= 80 cm/s A= 70 cm/s LAVI < 34 ml/m 2 1= Grade 1 2= Grade 2 3= Grade 3 4= Normal 5= Indeterminate 2018 MFMER 3712003-1 Choose the grading

More information

Mechanisms of heart failure with normal EF Arterial stiffness and ventricular-arterial coupling. What is the pathophysiology at presentation?

Mechanisms of heart failure with normal EF Arterial stiffness and ventricular-arterial coupling. What is the pathophysiology at presentation? Mechanisms of heart failure with normal EF Arterial stiffness and ventricular-arterial coupling What is the pathophysiology at presentation? Ventricular-arterial coupling elastance Central arterial pressure

More information

Tissue Doppler Imaging in Congenital Heart Disease

Tissue Doppler Imaging in Congenital Heart Disease Tissue Doppler Imaging in Congenital Heart Disease L. Youngmin Eun, M.D. Department of Pediatrics, Division of Pediatric Cardiology, Kwandong University College of Medicine The potential advantage of ultrasound

More information

Evaluation of Left Ventricular Diastolic Dysfunction by Doppler and 2D Speckle-tracking Imaging in Patients with Primary Pulmonary Hypertension

Evaluation of Left Ventricular Diastolic Dysfunction by Doppler and 2D Speckle-tracking Imaging in Patients with Primary Pulmonary Hypertension ESC Congress 2011.No 85975 Evaluation of Left Ventricular Diastolic Dysfunction by Doppler and 2D Speckle-tracking Imaging in Patients with Primary Pulmonary Hypertension Second Department of Internal

More information

i n d i a n h e a r t j o u r n a l 6 8 ( ) Available online at ScienceDirect

i n d i a n h e a r t j o u r n a l 6 8 ( ) Available online at  ScienceDirect i n d i a n h e a r t j o u r n a l 6 8 ( 2 0 1 6 ) 8 3 8 7 Available online at www.sciencedirect.com ScienceDirect journal homepage: www.elsevier.com/locate/ihj Original Article Myocardial Performance

More information

ECHO HAWAII. Role of Stress Echo in Valvular Heart Disease. Not only ischemia! Cardiomyopathy. Prosthetic Valve. Diastolic Dysfunction

ECHO HAWAII. Role of Stress Echo in Valvular Heart Disease. Not only ischemia! Cardiomyopathy. Prosthetic Valve. Diastolic Dysfunction Role of Stress Echo in Valvular Heart Disease ECHO HAWAII January 15 19, 2018 Kenya Kusunose, MD, PhD, FASE Tokushima University Hospital Japan Not only ischemia! Cardiomyopathy Prosthetic Valve Diastolic

More information

Right Heart Hemodynamics: Echo-Cath Discrepancies

Right Heart Hemodynamics: Echo-Cath Discrepancies Department of cardiac, thoracic and vascular sciences University of Padua, School of Medicine Padua, Italy Right Heart Hemodynamics: Echo-Cath Discrepancies Luigi P. Badano, MD, PhD, FESC, FACC **Dr. Badano

More information

Bogdan A. Popescu. University of Medicine and Pharmacy Bucharest, Romania. EAE Course, Bucharest, April 2010

Bogdan A. Popescu. University of Medicine and Pharmacy Bucharest, Romania. EAE Course, Bucharest, April 2010 Bogdan A. Popescu University of Medicine and Pharmacy Bucharest, Romania EAE Course, Bucharest, April 2010 This is how it started Mitral stenosis at a glance 2D echo narrow diastolic opening of MV leaflets

More information

Jong-Won Ha*, Jeong-Ah Ahn, Jae-Yun Moon, Hye-Sun Suh, Seok-Min Kang, Se-Joong Rim, Yangsoo Jang, Namsik Chung, Won-Heum Shim, Seung-Yun Cho

Jong-Won Ha*, Jeong-Ah Ahn, Jae-Yun Moon, Hye-Sun Suh, Seok-Min Kang, Se-Joong Rim, Yangsoo Jang, Namsik Chung, Won-Heum Shim, Seung-Yun Cho Eur J Echocardiography (2006) 7, 16e21 CLINICAL/ORIGINAL PAPERS Triphasic mitral inflow velocity with mid-diastolic flow: The presence of mid-diastolic mitral annular velocity indicates advanced diastolic

More information

Noninvasive assessment of left ventricular (LV)

Noninvasive assessment of left ventricular (LV) Comparative Value of Tissue Doppler Imaging and M-Mode Color Doppler Mitral Flow Propagation Velocity for the Evaluation of Left Ventricular Filling Pressure* Michal Kidawa, MD; Lisa Coignard, MD; Gérard

More information

The study of left ventricular diastolic function by Doppler echocardiography: the essential for the clinician

The study of left ventricular diastolic function by Doppler echocardiography: the essential for the clinician Heart International / Vol. 3 no. 1-2, 2007 / pp. 42-50 Wichtig Editore, 2007 Review The study of left ventricular diastolic function by Doppler echocardiography: the essential for the clinician POMPILIO

More information

Ref 1. Ref 2. Ref 3. Ref 4. See graph

Ref 1. Ref 2. Ref 3. Ref 4. See graph Ref 1 Ref 2 Ref 3 1. Ages 6-23 y/o 2. Significant LVM differences by gender 3. For males 95 th percentiles: a. LVM/BSA = 103 b. LVM/height = 100 4. For females 95 th percentiles: a. LVM/BSA = 84 b. LVM/height

More information

ΚΑΡΔΙΟΛΟΓΟΣ EUROPEAN ACCREDITATION IN TRANSTHORACIC AND TRANSESOPHAGEAL ECHOCARDIOGRAPHY

ΚΑΡΔΙΟΛΟΓΟΣ EUROPEAN ACCREDITATION IN TRANSTHORACIC AND TRANSESOPHAGEAL ECHOCARDIOGRAPHY 1 ΚΑΡΔΙΟΛΟΓΟΣ EUROPEAN ACCREDITATION IN TRANSTHORACIC AND TRANSESOPHAGEAL ECHOCARDIOGRAPHY 2 Constrictive pericarditis (CP) is characterized by impaired ventricular filling due to a stiffened or noncompliant

More information

Diastolic Heart Function: Applying the New Guidelines Case Studies

Diastolic Heart Function: Applying the New Guidelines Case Studies Diastolic Heart Function: Applying the New Guidelines Case Studies Mitral Regurgitation The New ASE William Guidelines: A. Zoghbi Role MD, of FASE, 2D/3D MACCand CMR Professor and Chairman, Department

More information

Characteristics of Left Ventricular Diastolic Function in Patients with Systolic Heart Failure: A Doppler Tissue Imaging Study

Characteristics of Left Ventricular Diastolic Function in Patients with Systolic Heart Failure: A Doppler Tissue Imaging Study Characteristics of Left Ventricular Diastolic Function in Patients with Systolic Heart Failure: A Doppler Tissue Imaging Study Bassem A. Samad, MD, PhD, Jens M. Olson, MD, and Mahbubul Alam, MD, PhD, FESC,

More information

Pericardial Diseases. Smonporn Boonyaratavej, MD. Division of Cardiology, Department of Medicine Chulalongkorn University

Pericardial Diseases. Smonporn Boonyaratavej, MD. Division of Cardiology, Department of Medicine Chulalongkorn University Pericardial Diseases Smonporn Boonyaratavej, MD Division of Cardiology, Department of Medicine Chulalongkorn University Cardiac Center, King Chulalongkorn Memorial Hospital 21 AUGUST 2016 Pericardial

More information

European Heart Journal - Cardiovascular Imaging Advance Access published July 18, 2016

European Heart Journal - Cardiovascular Imaging Advance Access published July 18, 2016 European Heart Journal - Cardiovascular Imaging Advance Access published July 18, 2016 European Heart Journal Cardiovascular Imaging doi:10.1093/ehjci/jew082 Recommendations for the Evaluation of Left

More information

Review of Cardiac Imaging Modalities in the Renal Patient. George Youssef

Review of Cardiac Imaging Modalities in the Renal Patient. George Youssef Review of Cardiac Imaging Modalities in the Renal Patient George Youssef ECHO Left ventricular hypertrophy (LVH) assessment Diastolic dysfunction Stress ECHO Cardiac CT angiography Echocardiography - positives

More information

Diastolic Heart Failure (HFpEF) Felix J. Rogers, DO, FACOI April 29, 2018

Diastolic Heart Failure (HFpEF) Felix J. Rogers, DO, FACOI April 29, 2018 Diastolic Heart Failure (HFpEF) Felix J. Rogers, DO, FACOI April 29, 2018 Case presentation MSO, an 81 year old woman was admitted to HFWH because of progressive dyspnea and difficult to control hypertension

More information

Mitral annular Doppler tissue imaging (DTI) has

Mitral annular Doppler tissue imaging (DTI) has CARDIAC SONOGRAPHERS COMMUNICATION Doppler Tissue Imaging for the Assessment of Left Ventricular Diastolic Function: A Systematic Approach for the Sonographer Jeffrey C. Hill, BS, RDCS, and Richie A. Palma,

More information

Diagnosis is it really Heart Failure?

Diagnosis is it really Heart Failure? ESC Congress Munich - 25-29 August 2012 Heart Failure with Preserved Ejection Fraction From Bench to Bedside Diagnosis is it really Heart Failure? Prof. Burkert Pieske Department of Cardiology Med.University

More information

Articles in PresS. J Appl Physiol (September 29, 2005). doi: /japplphysiol

Articles in PresS. J Appl Physiol (September 29, 2005). doi: /japplphysiol Articles in PresS. J Appl Physiol (September 29, 2005). doi:10.1152/japplphysiol.00671.2005 Assessment of Left Ventricular Diastolic Function by Early Diastolic Mitral Annulus Peak Acceleration Rate: Experimental

More information

Doppler Basic & Hemodynamic Calculations

Doppler Basic & Hemodynamic Calculations Doppler Basic & Hemodynamic Calculations August 19, 2017 Smonporn Boonyaratavej MD Division of Cardiology, Department of Medicine Chulalongkorn University Cardiac Center, King Chulalongkorn Memorial Hospital

More information

Elevated LV filling pressure is a major determinant of cardiac symptoms and

Elevated LV filling pressure is a major determinant of cardiac symptoms and LEFT VENTRICULAR FILLING PRESSURE, DIASTOLIC FUNCTION, AND HEART RATE PATRIZIO LANCELLOTTI, MD, PhD, FESC PERSPECTIVES Author affiliations: University of Liège hospital, GIGA Cardiovascular Science, Heart

More information

Atrial dyssynchrony syndrome: An overlooked cause of heart failure with normal ejection fraction

Atrial dyssynchrony syndrome: An overlooked cause of heart failure with normal ejection fraction Atrial dyssynchrony syndrome: An overlooked cause of heart failure with normal ejection fraction JC Eicher, G Laurent, O Barthez, A Mathé, G Bertaux, JE Wolf Heart Failure Treatment Unit, Rhythmology and

More information

THE PHARMA INNOVATION - JOURNAL Tei Index: Assessment of the Myocardial Function of the Left Ventricle in Case of Acute Myocardial Infarction

THE PHARMA INNOVATION - JOURNAL Tei Index: Assessment of the Myocardial Function of the Left Ventricle in Case of Acute Myocardial Infarction Received: 16-06-2013 Accepted: 13-07-2013 ISSN: 2277-7695 CODEN Code: PIHNBQ ZDB-Number: 2663038-2 IC Journal No: 7725 Vol. 2 No. 6 2013 Online Available at www.thepharmajournal.com THE PHARMA INNOVATION

More information

Value of echocardiography in chronic dyspnea

Value of echocardiography in chronic dyspnea Value of echocardiography in chronic dyspnea Jahrestagung Schweizerische Gesellschaft für /Schweizerische Gesellschaft für Pneumologie B. Kaufmann 16.06.2016 Chronic dyspnea Shortness of breath lasting

More information

ΚΑΡΔΙΑΚΗ ΑΝΕΠΑΡΚΕΙΑ ΜΕ ΔΙΑΤΗΡΗΜΕΝΟ ΚΛΑΣΜΑ ΕΞΩΘΗΣΗΣ

ΚΑΡΔΙΑΚΗ ΑΝΕΠΑΡΚΕΙΑ ΜΕ ΔΙΑΤΗΡΗΜΕΝΟ ΚΛΑΣΜΑ ΕΞΩΘΗΣΗΣ ΚΑΡΔΙΑΚΗ ΑΝΕΠΑΡΚΕΙΑ ΜΕ ΔΙΑΤΗΡΗΜΕΝΟ ΚΛΑΣΜΑ ΕΞΩΘΗΣΗΣ ΙΓΝΑΤΙΟΣ ΟΙΚΟΝΟΜΙΔΗΣ MD, PHD, FESC ΑΝΑΠΛΗΡΩΤΗΣ ΚΑΘΗΓΗΤΗΣ ΚΑΡΔΙΟΛΟΓΙΑΣ Β ΚΑΡΔΙΟΛΟΓΙΚΗ ΚΛΙΝΙΚΗ, ΕΘΝΙΚΌ ΚΑΙ ΚΑΠΟΔΙΣΤΡΙΑΚΌ ΠΑΝΕΠΙΣΤΗΜΙΟ ΑΘΗΝΩΝ ΝΟΣΟΚΟΜΕΙΟ

More information

Hypertensive heart disease and failure

Hypertensive heart disease and failure Hypertensive heart disease and failure Prof. Dr. Alan Fraser Cardiff University The heart in hypertension Pathophysiology of LV adaptation Regional development of hypertrophy Stress testing - inducible

More information

Journal of the American College of Cardiology Vol. 36, No. 5, by the American College of Cardiology ISSN /00/$20.

Journal of the American College of Cardiology Vol. 36, No. 5, by the American College of Cardiology ISSN /00/$20. Journal of the American College of Cardiology Vol. 36, No. 5, 2000 2000 by the American College of Cardiology ISSN 0735-1097/00/$20.00 Published by Elsevier Science Inc. PII S0735-1097(00)00909-8 Echocardiography

More information

Restrictive Cardiomyopathy

Restrictive Cardiomyopathy ESC Congress 2011, Paris Imaging Unusual Causes of Cardiomyopathy Restrictive Cardiomyopathy Kazuaki Tanabe, MD, PhD Professor of Medicine Chair, Division of Cardiology Izumo, Japan I Have No Disclosures

More information

DECLARATION OF CONFLICT OF INTEREST

DECLARATION OF CONFLICT OF INTEREST DECLARATION OF CONFLICT OF INTEREST ESC Congress 2011 Pathophysiology of HFPEF Vascular Remodeling & Pulmonary Hypertension Carolyn S.P. Lam MBBS, MRCP, MS Case Presentation 81 yo woman with dyspnoea &

More information

Echocardiographic evaluation of mitral stenosis

Echocardiographic evaluation of mitral stenosis Echocardiographic evaluation of mitral stenosis Euroecho 2011 Philippe Unger, MD, FESC Erasme Hospital, ULB, Brussels, Belgium I have nothing to declare EuroHeart Survey Etiology of single native left-sided

More information

Chapter 52 Diastolic Stress Echocardiography

Chapter 52 Diastolic Stress Echocardiography Chapter 52 Diastolic Stress Echocardiography SATISH C. GOVIND AASHA S. GOPAL ANATOLI KIOTSEKOGLOU SAMIR K. SAHA PHYSIOLOGY OF DIASTOLE Left ventricular (LV) diastole can typically be defined as a phase

More information

Is normal ejection fraction equivalent to normal systolic function?

Is normal ejection fraction equivalent to normal systolic function? Is normal ejection fraction equivalent to normal systolic function? D. Vinereanu University of Medicine, Bucharest, Romania EAE course, Bucharest No 2 nd criterion (out of 3) for the diagnosis of HFNEF:

More information

Valve Disease in the Pregnant Patient

Valve Disease in the Pregnant Patient Valve Disease in the Pregnant Patient Julie B. Damp, MD December 6, 2012 VanderbiltHeart.com If single, do not allow marriage. If fertile, do not allow pregnancy. If pregnant, do not allow delivery. If

More information

Rownak Jahan Tamanna 1, Rowshan Jahan 2, Abduz Zaher 3 and Abdul Kader Akhanda. 3 ORIGINAL ARTICLES

Rownak Jahan Tamanna 1, Rowshan Jahan 2, Abduz Zaher 3 and Abdul Kader Akhanda. 3 ORIGINAL ARTICLES University Heart Journal Vol. 4 No. 2 July 2008 ORIGINAL ARTICLES Correlation of Doppler echocardiography with cardiac catheterization in estimating pulmonary capillary wedge pressure: A tertiary level

More information

Diastolic Heart Failure

Diastolic Heart Failure 58 Diastolic Heart Failure Muhamed Saric and Itzhak Kronzon PRACTICAL POINTS Diastole starts with the closure of the aortic valve and ends with the closure of the mitral valve. It consists of four phases:

More information

Diastolic Function. Rick Nishimura Leighton Professor of CV Diseases Mayo Clinic No Disclosures

Diastolic Function. Rick Nishimura Leighton Professor of CV Diseases Mayo Clinic No Disclosures Diastolic Function Rick Nishimura Leighton Professor of CV Diseases Mayo Clinic No Disclosures Heart = Pump Heart Failure Systolic Dysfunction Diastolic Dysfunction Diastole is a complex sequence of multiple

More information

22 nd Annual Conference of the Saudi Heart Association Riyadh, Saudi Arabia

22 nd Annual Conference of the Saudi Heart Association Riyadh, Saudi Arabia 22 nd Annual Conference of the Saudi Heart Association Riyadh, Saudi Arabia New Echocardiographic Modalities to Evaluate Ventricular Function in Congenital Heart Disease: Tissue Doppler & Strain Rate Imaging

More information

Advanced imaging of the left atrium - strain, CT, 3D, MRI -

Advanced imaging of the left atrium - strain, CT, 3D, MRI - Advanced imaging of the left atrium - strain, CT, 3D, MRI - Monica Rosca, MD Carol Davila University of Medicine and Pharmacy, Bucharest, Romania Declaration of interest: I have nothing to declare Case

More information

Hypertrophic Cardiomyopathy

Hypertrophic Cardiomyopathy Hypertrophic Cardiomyopathy From Genetics to ECHO Alexandra A Frogoudaki Second Cardiology Department ATTIKON University Hospital Athens University Athens, Greece EUROECHO 2010, Copenhagen, 11/12/2010

More information

M. Hajahmadi Poorrafsanjani 1 & B. Rahimi Darabad 1

M. Hajahmadi Poorrafsanjani 1 & B. Rahimi Darabad 1 Global Journal of Health Science; Vol. 6, No. 7; 2014 ISSN 1916-9736 E-ISSN 1916-9744 Published by Canadian Center of Science and Education Evaluate the Sensitivity and Specificity Echocardiography in

More information

Michigan Society of Echocardiography 30 th Year Jubilee

Michigan Society of Echocardiography 30 th Year Jubilee Michigan Society of Echocardiography 30 th Year Jubilee Stress Echocardiography in Valvular Heart Disease Moving Beyond CAD Karthik Ananthasubramaniam, MD FRCP (Glas) FACC FASE FASNC Associate Professor

More information

Swan Song: Echocardiography as a Pulmonary Artery Catheter? Interdepartmental Division of Critical Care Medicine

Swan Song: Echocardiography as a Pulmonary Artery Catheter? Interdepartmental Division of Critical Care Medicine Swan Song: Echocardiography as a Pulmonary Artery Catheter? The swan is without spot, and it sings sweetly as it dies, that song ending its life Leonardo Da Vinci Curr Opin Anesthesiol 2016, 29:36 45 Circulation.

More information

Tissue Doppler Imaging

Tissue Doppler Imaging Cronicon OPEN ACCESS Hesham Rashid* Tissue Doppler Imaging CARDIOLOGY Editorial Department of Cardiology, Benha University, Egypt *Corresponding Author: Hesham Rashid, Department of Cardiology, Benha University,

More information

JACC: CARDIOVASCULAR IMAGING VOL. 4, NO. 9, PUBLISHED BY ELSEVIER INC. DOI: /j.jcmg

JACC: CARDIOVASCULAR IMAGING VOL. 4, NO. 9, PUBLISHED BY ELSEVIER INC. DOI: /j.jcmg JACC: CARDIOVASCULAR IMAGING VOL. 4, NO. 9, 2011 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-878X/$36.00 PUBLISHED BY ELSEVIER INC. DOI:10.1016/j.jcmg.2011.07.004 ORIGINAL RESEARCH

More information

Evaluation of the Right Ventricle in Candidates for Right Ventricular Assist Device Implantation.

Evaluation of the Right Ventricle in Candidates for Right Ventricular Assist Device Implantation. Evaluation of the Right Ventricle in Candidates for Right Ventricular Assist Device Implantation. Evaluation of RVAD Function. Ioannis A Paraskevaidis Attikon University Hospital Historical Perspective

More information

The Use of Left Ventricular Myocardial Stiffness Index as a Predictor of Myocardial Performance in Patients with Systemic Hypertension

The Use of Left Ventricular Myocardial Stiffness Index as a Predictor of Myocardial Performance in Patients with Systemic Hypertension International Journal of Medical Physics, Clinical Engineering and Radiation Oncology, 2014, 3, 167-175 Published Online August 2014 in SciRes. http://www.scirp.org/journal/ijmpcero http://dx.doi.org/10.4236/ijmpcero.2014.33022

More information

Η ηχωκαρδιολογία στην διάγνωση κα πρόγνωση της καρδιακής ανεπάρκειας µε µειωµένο και φυσιολογικό κλάσµα εξώθησης

Η ηχωκαρδιολογία στην διάγνωση κα πρόγνωση της καρδιακής ανεπάρκειας µε µειωµένο και φυσιολογικό κλάσµα εξώθησης Η ηχωκαρδιολογία στην διάγνωση κα πρόγνωση της καρδιακής ανεπάρκειας µε µειωµένο και φυσιολογικό κλάσµα εξώθησης Βασίλειος Σαχπεκίδης Επιµελητής Β Καρδιολογίας Γ.Ν. Παπαγεωργίου Θεσσαλονίκη ESC Guidelines

More information

Diastolic Dysfunction in the Presence of Left Ventricular Systolic Dysfunction: Implications of ß-Adrenergic Blocking Therapy

Diastolic Dysfunction in the Presence of Left Ventricular Systolic Dysfunction: Implications of ß-Adrenergic Blocking Therapy DIASTOLIC DYSFUNCTION CHF MARCH/APRIL 2001 71 Diastolic Dysfunction in the Presence of Left Ventricular Systolic Dysfunction: Implications of ß-Adrenergic Blocking Therapy The contribution of left ventricular

More information

좌심실수축기능평가 Cardiac Function

좌심실수축기능평가 Cardiac Function Basic Echo Review Course 좌심실수축기능평가 Cardiac Function Seonghoon Choi Cardiology Hallym university LV systolic function Systolic function 좌심실수축기능 - 심근의수축으로심실에서혈액을대동맥으로박출하는기능 실제임상에서 LV function 의의미 1Diagnosis

More information

Echocardiography: Guidelines for Valve Quantification

Echocardiography: Guidelines for Valve Quantification Echocardiography: Guidelines for Echocardiography: Guidelines for Chamber Quantification British Society of Echocardiography Education Committee Richard Steeds (Chair), Gill Wharton (Lead Author), Jane

More information

Hemodynamic Assessment. Assessment of Systolic Function Doppler Hemodynamics

Hemodynamic Assessment. Assessment of Systolic Function Doppler Hemodynamics Hemodynamic Assessment Matt M. Umland, RDCS, FASE Aurora Medical Group Milwaukee, WI Assessment of Systolic Function Doppler Hemodynamics Stroke Volume Cardiac Output Cardiac Index Tei Index/Index of myocardial

More information

Echocardiographic and Doppler Assessment of Cardiac Functions in Patients of Non-Insulin Dependent Diabetes Mellitus

Echocardiographic and Doppler Assessment of Cardiac Functions in Patients of Non-Insulin Dependent Diabetes Mellitus ORIGINAL ARTICLE JIACM 2002; 3(2): 164-8 Echocardiographic and Doppler Assessment of Cardiac Functions in Patients of Non-Insulin Dependent Diabetes Mellitus Rajesh Rajput*, Jagdish**, SB Siwach***, A

More information

The right ventricle in chronic heart failure

The right ventricle in chronic heart failure The right ventricle in chronic heart failure ESC 2012 Christian Opitz, Berlin There are no conflicts of interest relevant to this presentation Percent of Population Prevalence of Heart Failure by Age and

More information

We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors

We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 4,100 116,000 120M Open access books available International authors and editors Downloads Our

More information

In patients with aortic dissection, expansion of the false

In patients with aortic dissection, expansion of the false Left Ventricular Diastolic Dysfunction in Chronic Aortic Dissection Yasushige Shingu, MD, Norihiko Shiiya, MD, PhD, Taisei Mikami, MD, PhD, Kenji Matsuzaki, MD, Takashi Kunihara, MD, PhD, and Yoshiro Matsui,

More information

Contribution of Ventricular Diastolic Dysfunction to Pulmonary Hypertension Complicating Chronic Systolic Heart Failure

Contribution of Ventricular Diastolic Dysfunction to Pulmonary Hypertension Complicating Chronic Systolic Heart Failure JACC: CARDIOVASCULAR IMAGING VOL. 4, NO. 9, 2011 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-878X/$36.00 PUBLISHED BY ELSEVIER INC. DOI:10.1016/j.jcmg.2011.06.017 Contribution of Ventricular

More information

Journal of the American College of Cardiology Vol. 34, No. 2, by the American College of Cardiology ISSN /99/$20.

Journal of the American College of Cardiology Vol. 34, No. 2, by the American College of Cardiology ISSN /99/$20. Journal of the American College of Cardiology Vol. 34, No. 2, 1999 1999 by the American College of Cardiology ISSN 0735-1097/99/$20.00 Published by Elsevier Science Inc. PII S0735-1097(99)00230-2 Combined

More information