Review article
Diastolic Function: A Sonographer’s Approach to the Essential Echocardiographic Measurements of Left Ventricular Diastolic Function

https://doi.org/10.1016/j.echo.2006.08.005Get rights and content

Noninvasive assessment of left ventricular filling pressures by echocardiography has been validated by invasive hemodynamic studies and correlated with clinical findings. A comprehensive echocardiographic examination based on the referral diagnosis and patient symptomatology routinely includes efforts to measure specific parameters of left ventricular diastolic function. We provide a step-by-step approach to goal-directed echocardiographic assessment of diastolic function.

Section snippets

Imaging Views and Techniques

The echocardiographic acquisition of diastolic parameters is best accomplished when integrated within a standardized examination. Current state-of-the-art assessment of LV diastolic function is acquired from the apical tomographic imaging planes. Specifically, the sonographer presents apical 4-chamber, 2-chamber, and apical long-axis views that include the LV and the left atrium (LA). Every effort should be made to limit foreshortened imaging of the chambers to provide the reviewer with a

Assessment of LA Volume

Increased indexed LA volumes, obtained at the end of LV systole, have been shown to have clinically significant correlation with chronically elevated LV filling pressures.11, 12 Apical 4- and 2-chamber views allow acquisition of the required measurements needed to calculate LA volumes either by Simpson vs rule or the area-length method.10, 13, 14 Whereas LA volume determination by Simpson vs rule is accomplished by using the onboard calculation software of the ultrasound machine, the

Discussion

Our step-by-step approach and image-optimizing suggestions may be used to facilitate the essential echocardiographic diastolic assessment. A list of the measurements and their corresponding views and related imaging suggestions are provided in Table 3, Table 4. The comprehensive echocardiogram should include an assessment of diastolic function. An acquisition of diastolic filling parameters, readily obtainable in most patients, provides the reviewing echocardiographer with the necessary data to

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