Diastolic Function

Information about left ventricular function was traditionally provided primarily with measures of systolic function. Including the assessment of diastolic function has become an integral part of the evaluation of left ventricular function. Echocardiographic parameters of structure and Doppler provide information on each portion of the diastolic phases. These diastolic phases indicate change as impairment in diastolic function becomes more severe. This review of diastolic function provides the background as well as the techniques for clinical assessment of diastolic function in adult transthoracic echocardiography.

Importance of Recording Pulmonary Venous Flow Velocities With Transthoracic or Transesophagea1 Echocartiography

The recording of pulmonary venous flow velocities during Doppler ecgicardiography has not received sufficient attention. This review emphasizes the importance of recording pulmonary venous flow velocities (systolic, diastolic, and atrial reversal components) during transthoracic or transesophageal echocardiography. Clinical conditions that increase left atrial pressure, such as congestive heart failure, or that alter left atrial contraction (i.e., atrial fibrillation) result in diminished systolic pulmonary venous inflow and relatively increased diastolic pulmonary venous inflow. When moderate or severe mitral regurgitation is present or suspected by color Doppler imaging, pulmonary venous systolic flow will be blunted or exhibit systolic revetrsal. Distinctive patterns of respiratory variation in systolic and diastolic pulmonary venous velocities can be observed in patients with constrictive heart failure and elevated left ventricular end diastolic pressures but with normal mitral inflow patterns have abnormal pulmonary venous flow characteristics. Stenosis of the pulmonary may demonsterate increased pulmonary venous velocities or flow disturbances after postoperative repair. Pulmonary venous flow characteristics provide hemodynamic infomation not provided by other Doppler monalities or echocardiographic imaging.