REVIEW ARTICLES
New Doppler echocardiographic applications for the study of diastolic function
Mario J. Garcia, MD, FACCa,
James D. Thomas, MD, FACCa and
Allan L. Klein, MD, FACCa
a Cardiovascular Imaging Center, Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio, USA
Manuscript received April 7, 1998;
revised manuscript received June 9, 1998,
accepted June 17, 1998.
Address for correspondence: Dr. Mario J. Garcia, Desk F-15, Division of Cardiology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195
garciam{at}cesmtp.ccf.org
Doppler echocardiography is one of the most useful clinical tools for the assessment of left ventricular (LV) diastolic function. Doppler indices of LV filling and pulmonary venous (PV) flow are used not only for diagnostic purposes but also for establishing prognosis and evaluating the effect of therapeutic interventions. The utility of these indices is limited, however, by the confounding effects of different physiologic variables such as LV relaxation, compliance and filling pressure. Since alterations in these variables result in changes in Doppler indices of opposite direction, it is often difficult to determine the status of a given variable when a specific Doppler filling pattern is observed. Recently, color M-mode and tissue Doppler have provided useful insights in the study of diastolic function. These new Doppler applications have been shown to provide an accurate estimate of LV relaxation and appear to be relatively insensitive to the effects of preload compensation. This review will focus on the complementary role of color M-mode and tissue Doppler echocardiography and traditional Doppler indices of LV filling and PV flow in the assessment of diastolic function.
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Abbreviations and Acronyms
| | Am | = peak diastolic myocardial velocity during atrial contraction | | AR | = peak pulmonary venous atrial reversal velocity | | D | = peak diastolic pulmonary venous flow velocity | | DT | = early filling deceleration time | | E | = peak early transmitral flow velocity | | Em | = peak early diastolic myocardial velocity | | IVRT | = isovolumic relaxation time | | LA | = left atrial | | LV | = left ventricular | | PV | = pulmonary vein | | S | = peak systolic pulmonary venous flow | | Sm | = peak systolic myocardial velocity |  | = time constant of isovolumic relaxation | | TD | = color M-mode time delay to apical filling | | TDE | = tissue Doppler echocardiography | | Vp | = color M-mode flow propagation velocity |
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O. Kamp
Advanced Systolic and Diastolic Function: Beyond the E-and A-wave
Seminars in Cardiothoracic and Vascular Anesthesia,
March 1, 2006;
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[Abstract]
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J. Poelaert
The Failing Heart Under Stress: Echocardiography is an Essential Monitoring Tool in the Intensive Care Unit
Seminars in Cardiothoracic and Vascular Anesthesia,
March 1, 2006;
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[Abstract]
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R. E. Gilbert, K. Connelly, D. J. Kelly, C. A. Pollock, and H. Krum
Heart Failure and Nephropathy: Catastrophic and Interrelated Complications of Diabetes
Clin. J. Am. Soc. Nephrol.,
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[Abstract]
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S. Y. Hayashi, M. Rohani, B. Lindholm, L.-A. Brodin, B. Lind, P. Barany, A. Alvestrand, and A. Seeberger
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Nephrol. Dial. Transplant.,
January 1, 2006;
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[Abstract]
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R. Valle, E. Bagolin, C. Canali, P. Giovinazzo, S. Barro, N. Aspromonte, E. Carbonieri, and L. Milani
The BNP assay does not identify mild left ventricular diastolic dysfunction in asymptomatic diabetic patients
Eur J Echocardiogr,
January 1, 2006;
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[Abstract]
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R. Talens-Visconti, M. Rivera Otero, M. J. Sancho-Tello, F. G. de Burgos, L. Martinez-Dolz, B. Sevilla, V. Climent, R. Cortes, A. Salvador, F. Sogorb, et al.
Left ventricular cavity area reflects N-terminal pro-brain natriuretic peptide plasma levels in heart failure
Eur J Echocardiogr,
January 1, 2006;
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[Abstract]
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A. D. Waggoner, M. N. Faddis, M. J. Gleva, L. de las Fuentes, and V. G. Davila-Roman
Improvements in Left Ventricular Diastolic Function After Cardiac Resynchronization Therapy Are Coupled to Response in Systolic Performance
J. Am. Coll. Cardiol.,
December 20, 2005;
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[Abstract]
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F. H Rutten, K. G M Moons, M.-J. M Cramer, D. E Grobbee, N. P A Zuithoff, J.-W. J Lammers, and A. W Hoes
Recognising heart failure in elderly patients with stable chronic obstructive pulmonary disease in primary care: cross sectional diagnostic study
BMJ,
December 10, 2005;
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[Abstract]
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P M Mottram, B A Haluska, R Leano, S Carlier, C Case, and T H Marwick
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Heart,
December 1, 2005;
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[Abstract]
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M. Guazzi, J. Myers, and R. Arena
Cardiopulmonary Exercise Testing in the Clinical and Prognostic Assessment of Diastolic Heart Failure
J. Am. Coll. Cardiol.,
November 15, 2005;
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[Abstract]
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K. George, D. Oxborough, J. Forster, G. Whyte, R. Shave, E. Dawson, C. Stephenson, L. Dugdill, B. Edwards, and D. Gaze
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November 15, 2005;
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[Abstract]
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H. Izawa, T. Murohara, K. Nagata, S. Isobe, H. Asano, T. Amano, S. Ichihara, T. Kato, S. Ohshima, Y. Murase, et al.
Mineralocorticoid Receptor Antagonism Ameliorates Left Ventricular Diastolic Dysfunction and Myocardial Fibrosis in Mildly Symptomatic Patients With Idiopathic Dilated Cardiomyopathy: A Pilot Study
Circulation,
November 8, 2005;
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[Abstract]
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P. Reant, S. Lafitte, P. Jais, K. Serri, R. Weerasooriya, M. Hocini, X. Pillois, J. Clementy, M. Haissaguerre, and R. Roudaut
Reverse Remodeling of the Left Cardiac Chambers After Catheter Ablation After 1 Year in a Series of Patients With Isolated Atrial Fibrillation
Circulation,
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[Abstract]
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M. Kidawa, L. Coignard, G. Drobinski, M. Krzeminska-Pakula, D. Thomas, M. Komajda, and R. Isnard
Comparative Value of Tissue Doppler Imaging and M-Mode Color Doppler Mitral Flow Propagation Velocity for the Evaluation of Left Ventricular Filling Pressure
Chest,
October 1, 2005;
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[Abstract]
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F. H. Rutten, M.-J. M. Cramer, D. E. Grobbee, A. P.E. Sachs, J. H. Kirkels, J.-W. J. Lammers, and A. W. Hoes
Unrecognized heart failure in elderly patients with stable chronic obstructive pulmonary disease
Eur. Heart J.,
September 2, 2005;
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D. Vinereanu, E. Nicolaides, A. C. Tweddel, and A. G. Fraser
"Pure" diastolic dysfunction is associated with long-axis systolic dysfunction. Implications for the diagnosis and classification of heart failure
Eur J Heart Fail,
August 1, 2005;
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[Abstract]
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Y. Okura, Y. Nakashima, H. Tojo, E. Tashiro, and K. Saku
Valsartan, an Angiotensin II Type-I Receptor Blocker, and Left Ventricular Diastolic Function: A Case Report
Angiology,
July 1, 2005;
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[Abstract]
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M. Tretjak, F. Verovnik, D. Benko, and M. Kozelj
Tissue Doppler velocities of mitral annulus and NT-proBNP in patients with heart failure
Eur J Heart Fail,
June 1, 2005;
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[Abstract]
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C. Schmidt, F. Hinder, H. Van Aken, G. Theilmeier, C. Bruch, S. P. Wirtz, H. Burkle, T. Guhs, M. Rothenburger, and E. Berendes
The Effect of High Thoracic Epidural Anesthesia on Systolic and Diastolic Left Ventricular Function in Patients with Coronary Artery Disease
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[Abstract]
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S H Poulsen, N H Andersen, L Heickendorff, and C E Mogensen
Relation between plasma amino-terminal propeptide of procollagen type III and left ventricular longitudinal strain in essential hypertension
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May 1, 2005;
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[Abstract]
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P. M Mottram and T. H Marwick
Assessment of diastolic function: what the general cardiologist needs to know
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C. Bruch, M. Gotzmann, J. Stypmann, F. Wenzelburger, M. Rothenburger, M. Grude, H. H. Scheld, L. Eckardt, G. Breithardt, and T. Wichter
Electrocardiography and Doppler echocardiography for risk stratification in patients with chronic heart failure: Incremental prognostic value of QRS duration and a restrictive mitral filling pattern
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April 5, 2005;
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[Abstract]
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P. M. Srivastava, L. M. Burrell, and P. Calafiore
Lateral vs medial mitral annular tissue Doppler in the echocardiographic assessment of diastolic function and filling pressures: which should we use?
Eur J Echocardiogr,
March 1, 2005;
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[Abstract]
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M. Wang, G. Yip, C.-M. Yu, Q. Zhang, Y. Zhang, D. Tse, S.-L. Kong, and J. E. Sanderson
Independent and incremental prognostic value of early mitral annulus velocity in patients with impaired left ventricular systolic function
J. Am. Coll. Cardiol.,
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[Abstract]
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B. W.L. De Boeck, J. K. Oh, P. M. Vandervoort, J. A. Vierendeels, R. P.L.M. van der Aa, and M.-J. M. Cramer
Colour M-mode velocity propagation: a glance at intra-ventricular pressure gradients and early diastolic ventricular performance
Eur J Heart Fail,
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R. Pop-Busui, I. Kirkwood, H. Schmid, V. Marinescu, J. Schroeder, D. Larkin, E. Yamada, D. M. Raffel, and M. J. Stevens
Sympathetic dysfunction in type 1 diabetes: Association with impaired myocardial blood flow reserve and diastolic dysfunction
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J. C. Garcia-Rubira, M. A. Cobos, and A. I. Fernadez-Ortiz
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