TY - JOUR
T1 - Diastolic dysfunction
T2 - Can it be diagnosed by Doppler echocardiography?
AU - Maurer, Mathew S.
AU - Spevack, Daniel
AU - Burkhoff, Daniel
AU - Kronzon, Itzhak
N1 - Funding Information:
Dr. Maurer is supported by a Career Development Award from the National Institute on Aging (K23-AG00966).
PY - 2004/10/19
Y1 - 2004/10/19
N2 - Heart failure with a normal ejection fraction (HFNEF) predominately afflicts older, female individuals and is considered to be a consequence of diastolic dysfunction. Doppler echocardiography has become the standard method for identifying and characterizing diastolic function. However, the important distinction between Doppler measures of filling dynamics and true indexes of intrinsic ventricular diastolic chamber properties is not widely appreciated. Herein, we delineate physiologic measures of intrinsic ventricular diastolic function, as determined by pressure volume analysis, and compare and contrast these measures with those derived from Doppler echocardiography. Doppler-derived indexes of ventricular filling do not provide specific information on intrinsic passive diastolic properties, and thus, abnormal filling dynamics do not necessarily equate with intrinsic myocardial diastolic dysfunction. This raises a fundamental question as to whether delayed relaxation and/or stiffened passive properties are the unifying pathophysiologic mechanisms in all patients who present with HFNEF.
AB - Heart failure with a normal ejection fraction (HFNEF) predominately afflicts older, female individuals and is considered to be a consequence of diastolic dysfunction. Doppler echocardiography has become the standard method for identifying and characterizing diastolic function. However, the important distinction between Doppler measures of filling dynamics and true indexes of intrinsic ventricular diastolic chamber properties is not widely appreciated. Herein, we delineate physiologic measures of intrinsic ventricular diastolic function, as determined by pressure volume analysis, and compare and contrast these measures with those derived from Doppler echocardiography. Doppler-derived indexes of ventricular filling do not provide specific information on intrinsic passive diastolic properties, and thus, abnormal filling dynamics do not necessarily equate with intrinsic myocardial diastolic dysfunction. This raises a fundamental question as to whether delayed relaxation and/or stiffened passive properties are the unifying pathophysiologic mechanisms in all patients who present with HFNEF.
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U2 - 10.1016/j.jacc.2004.07.034
DO - 10.1016/j.jacc.2004.07.034
M3 - Review article
C2 - 15489083
AN - SCOPUS:5644232173
SN - 0735-1097
VL - 44
SP - 1543
EP - 1549
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 8
ER -