Dialogues in Cardiovascular Medicine - Vol 4 . No. 4 . 1999





What is the best way to measure
diastolic dysfunction?



     Diastolic dysfunction is defined by symptoms of heart failure in the presence of normal systolic pump function. Its assessment is difficult in the clinical setting, and must rely on noninvasive and invasive techniques to detect changes in relaxation, filling, and distensibility. One of the most commonly used diagnostic techniques is Dopplerechocardiography, which distinguishes diastolic dysfunction from abnormal transmitral flow patterns, altered pulmonary venous flow, and unrelated changes in tissue imaging parameters (diastolic abnormalities). As it may fail to take into account pseudonormalization of flow signals and changes in loading conditions that can mask diastolic dysfunction, cardiac catheterization is often necessary for a reliable quantitation of relaxation disturbances (time constant of pressure decay), changes in filling pressure (increase in minimal diastolic and end-diastolic pressure), and diastolic distensibility (pressurevolume and stress-strain data)...






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