STATE-OF-THE-ART PAPER
Unlocking the Mysteries of Diastolic FunctionDeciphering the Rosetta Stone 10 Years Later
Steven J. Lester, MD, FACC, FRCPC, FASE*,*,
A. Jamil Tajik, MD, FACC*,
Rick A. Nishimura, MD, FACC ,
Jae K. Oh, MD,
Bijoy K. Khandheria, MBBS, FACC, FASE, FESC* and
James B. Seward, MD, FACC
* Division of Cardiovascular Disease, Mayo Clinic, Scottsdale, Arizona
Mayo Clinic, Rochester, Minnesota.
Manuscript received August 9, 2007;
revised manuscript received September 20, 2007,
accepted September 24, 2007.
* Reprint requests and correspondence: Dr. Steven J. Lester, Cardiovascular Diseases, Mayo Clinic Arizona, 13400 East Shea Boulevard, Scottsdale, Arizona 85259. (Email: lester.steven{at}mayo.edu).
It has now been a quarter of a century since the first description by Kitabatake and his associates of the use of echo-Doppler to characterize the transmitral flow velocity curves in various disease states. A decade ago we described the role of echocardiography in the "Evaluation of Diastolic Filling of Left Ventricle in Health and Disease: Doppler Echocardiography Is the Clinician’s Rosetta Stone." Over the ensuing decade, advances in echo-Doppler have helped to further decipher the morphologic and physiological expression of cardiovascular disease and unlock additional mysteries of diastology. The purpose of this review is to highlight the developments in echo-Doppler and refinements in our knowledge that have occurred over the past decade that enhance our understanding of diastology.
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Abbreviations and Acronyms
| | A = A velocity | | ACEI = angiotensin-converting enzyme inhibitor | | ARA = aldosterone receptor antagonist | | ARB = angiotensin I receptor antagonist | | DT = deceleration time | | DTI = Doppler tissue imaging | | E = E velocity | | Ea = arterial elastance | | IVRT = isovolumic relaxation time | | LA = left atrium | | LV = left ventricle/ventricular | | LVOT = left ventricular outflow tract | | SRivr = strain rate during the isovolumic relaxation phase of the cardiac cycle | | Vp = mitral inflow propagation velocity |
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|
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|
|
|
|
|
|
|
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(2011)
ehr378v1.
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|
|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
|
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|
|
|
|
|
|
|
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August 1, 2011;
111(2):
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|
|
|
|
|
|
|
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12(5):
339 - 353.
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|
|
|
|
|
|
|
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|
|
|
|
|
|
|
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Ann. Thorac. Surg.,
March 1, 2011;
91(3):
685 - 691.
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[Full Text]
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|
|
|
|
|
|
|
A. C. Boyd, N. B. Schiller, D. Leung, D. L. Ross, and L. Thomas
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4(3):
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|
|
|
|
|
|
|
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|
|
|
|
|
|
|
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|
|
|
|
|
|
|
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|
|
|
|
|
|
|
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|
|
|
|
|
|
|
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|
|
|
|
|
|
|
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Arterioscler Thromb Vasc Biol,
January 1, 2011;
31(1):
197 - 202.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Caudron, J. Fares, F. Bauer, and J.-N. Dacher
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RadioGraphics,
January 1, 2011;
31(1):
239 - 259.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Y. H. Lip, H.-F. Tse, and A. J. Stewart Coats
Echocardiography
ODR Cardiology,
January 1, 2011;
1(1):
med-9780199568093-div1-00 - med-9780199568093-div1-00.
[Full Text]
|
|
|
|
|
|
|
A. P.-W. Lee, J.-K. Song, G. W.-K. Yip, Q. Zhang, T.-G. Zhu, C. Li, A. Chan, and C.-M. Yu
Importance of dynamic dyssynchrony in the occurrence of hypertensive heart failure with normal ejection fraction
Eur. Heart J.,
November 1, 2010;
31(21):
2642 - 2649.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. A. ten Brinke, M. Bertini, R. J. Klautz, M. L. Antoni, E. R. Holman, N. R. van de Veire, J. J. Bax, and P. Steendijk
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J. Thorac. Cardiovasc. Surg.,
October 1, 2010;
140(4):
807 - 815.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. L. Baggish, R. B. Weiner, G. Kanayama, J. I. Hudson, M. H. Picard, A. M. Hutter Jr, and H. G. Pope Jr
Long-Term Anabolic-Androgenic Steroid Use Is Associated With Left Ventricular Dysfunction
Circ Heart Fail,
July 1, 2010;
3(4):
472 - 476.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Nucifora, N. A. Marsan, M. Bertini, V. Delgado, H.-M. J. Siebelink, J. M. van Werkhoven, A. J. Scholte, M. J. Schalij, E. E. van der Wall, E. R. Holman, et al.
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Circ Cardiovasc Imaging,
July 1, 2010;
3(4):
433 - 442.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Girardi, E. Franceschi, and A. A. Brandes
Cardiovascular Safety of VEGF-Targeting Therapies: Current Evidence and Handling Strategies
Oncologist,
July 1, 2010;
15(7):
683 - 694.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. L. Antoni, R. W. C. Scherptong, J. Z. Atary, E. Boersma, E. R. Holman, E. E. van der Wall, M. J. Schalij, and J. J. Bax
Prognostic Value of Right Ventricular Function in Patients After Acute Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention
Circ Cardiovasc Imaging,
May 1, 2010;
3(3):
264 - 271.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. A. Silberman, T.-H. M. Fan, H. Liu, Z. Jiao, H. D. Xiao, J. D. Lovelock, B. M. Boulden, J. Widder, S. Fredd, K. E. Bernstein, et al.
Uncoupled Cardiac Nitric Oxide Synthase Mediates Diastolic Dysfunction
Circulation,
February 2, 2010;
121(4):
519 - 528.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. A. ten Brinke, D. Burkhoff, R. J. Klautz, C. Tschope, M. J. Schalij, J. J. Bax, E. E. van der Wall, R. A. Dion, and P. Steendijk
Single-beat estimation of the left ventricular end-diastolic pressure-volume relationship in patients with heart failure
Heart,
February 1, 2010;
96(3):
213 - 219.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Sam, T.-A. S. Duhaney, K. Sato, R. M. Wilson, K. Ohashi, S. Sono-Romanelli, A. Higuchi, D. S. De Silva, F. Qin, K. Walsh, et al.
Adiponectin Deficiency, Diastolic Dysfunction, and Diastolic Heart Failure
Endocrinology,
January 1, 2010;
151(1):
322 - 331.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C.-M. Yu, J. Y.-S. Chan, Q. Zhang, G. W.K. Yip, Y.-Y. Lam, A. Chan, D. Burkhoff, P.-W. Lee, and J. W.-H. Fung
Impact of Cardiac Contractility Modulation on Left Ventricular Global and Regional Function and Remodeling
J. Am. Coll. Cardiol. Img.,
December 1, 2009;
2(12):
1341 - 1349.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Moreo, G. Ambrosio, B. De Chiara, M. Pu, T. Tran, F. Mauri, and S. V. Raman
Influence of Myocardial Fibrosis on Left Ventricular Diastolic Function: Noninvasive Assessment by Cardiac Magnetic Resonance and Echo
Circ Cardiovasc Imaging,
November 1, 2009;
2(6):
437 - 443.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. V. Shah, A. A. Chen-Tournoux, M. H. Picard, and J. L. Januzzi
Association between troponin T and impaired left ventricular relaxation in patients with acute decompensated heart failure with preserved systolic function
Eur Heart J Cardiovasc Imaging,
August 1, 2009;
10(6):
765 - 768.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Carluccio, P. Biagioli, G. Alunni, A. Murrone, V. Leonelli, P. Pantano, G. Vincenti, C. Giombolini, T. Ragni, G. Reboldi, et al.
Effect of revascularizing viable myocardium on left ventricular diastolic function in patients with ischaemic cardiomyopathy
Eur. Heart J.,
June 2, 2009;
30(12):
1501 - 1509.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. T. Burns, A. La Gerche, D. L. Prior, and A. I. MacIsaac
Left Ventricular Untwisting Is an Important Determinant of Early Diastolic Function
J. Am. Coll. Cardiol. Img.,
June 1, 2009;
2(6):
709 - 716.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. F. Tops, D. W. Den Uijl, V. Delgado, N. A. Marsan, K. Zeppenfeld, E. Holman, E. E. van der Wall, M. J. Schalij, and J. J. Bax
Long-Term Improvement in Left Ventricular Strain After Successful Catheter Ablation for Atrial Fibrillation in Patients With Preserved Left Ventricular Systolic Function
Circ Arrhythm Electrophysiol,
June 1, 2009;
2(3):
249 - 257.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. L. Dini, F. Lattanzi, P. Fontanive, G. M. Rosa, and S. M. De Tommasi
Value of tissue Doppler imaging for risk stratification of patients with chronic systolic heart failure with or without restrictive mitral flow
Eur Heart J Cardiovasc Imaging,
June 1, 2009;
10(4):
562 - 566.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y-Y Lam, M J Mullen, M G Kaya, M A Gatzoulis, W Li, and M Y Henein
Left ventricular long axis dysfunction in adults with "corrected" aortic coarctation is related to an older age at intervention and increased aortic stiffness
Heart,
May 1, 2009;
95(9):
733 - 739.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I A Paraskevaidis, F Panou, C Papadopoulos, D Farmakis, J Parissis, I Ikonomidis, A Rigopoulos, E K Iliodromitis, and D Th Kremastinos
Evaluation of left atrial longitudinal function in patients with hypertrophic cardiomyopathy: a tissue Doppler imaging and two-dimensional strain study
Heart,
March 15, 2009;
95(6):
483 - 489.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Kuznetsova, L. Herbots, B. Lopez, Y. Jin, T. Richart, L. Thijs, A. Gonzalez, M.-C. Herregods, R. H. Fagard, J. Diez, et al.
Prevalence of Left Ventricular Diastolic Dysfunction in a General Population
Circ Heart Fail,
March 1, 2009;
2(2):
105 - 112.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. W. Troughton and A. M. Richards
B-type natriuretic peptides and echocardiographic measures of cardiac structure and function.
J. Am. Coll. Cardiol. Img.,
February 1, 2009;
2(2):
216 - 225.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M Saito, H Okayama, K Nishimura, A Ogimoto, T Ohtsuka, K Inoue, G Hiasa, T Sumimoto, J Funada, Y Shigematsu, et al.
Determinants of left ventricular untwisting behaviour in patients with dilated cardiomyopathy: analysis by two-dimensional speckle tracking
Heart,
February 1, 2009;
95(4):
290 - 296.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. N. DeMaria, O. Ben-Yehuda, J. J. Bax, G. K. Feld, B. H. Greenberg, W. Y.W. Lew, J. A.C. Lima, A. S. Maisel, S. M. Narayan, D. J. Sahn, et al.
Highlights of the Year in JACC 2008
J. Am. Coll. Cardiol.,
January 27, 2009;
53(4):
373 - 398.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Y-M. Wang, M. Wang, C. W-K. Lam, I. H-S. Chan, Y. Zhang, and J. E. Sanderson
Left Ventricular Filling Pressure by Doppler Echocardiography in Patients With End-Stage Renal Disease
Hypertension,
July 1, 2008;
52(1):
107 - 114.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
