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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