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Figure 1 Classification of LV Diastolic Function

Left ventricular (LV) diastolic function categorized into 4 groups. 1) Normal: mitral inflow parameters within normal range and normal pulmonary vein flow or normal N-terminal pro-brain natriuretic peptide (NT-proBNP). 2) Abnormal relaxation: a) early filling peak velocity/atrial filling peak velocity (E/A) ratio lower than age-related value and/or b) isovolumic relaxation time/deceleration time (IVRT/DT) longer than age-related value. 3) Pseudonormal: normal mitral inflow parameters and a) elevated NT-proBNP, b) abnormal pulmonary venous flow, or c) abnormal E/A–E/A during Valsalva. 4) Restrictive: a) E/A ratio higher than age-related value and/or b) IVRT/DT shorter than age-related value. Pulmonary venous flow was considered abnormal if any one of the following criteria were present: 1) pulmonary vein systolic/diastolic velocity less than age-related value, 2) pulmonary vein a-duration longer than mitral a-duration, or 3) pulmonary vein peak a-velocity greater than age-related value. Normal values are in Table 1.