Diastolic dysfunction Other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shankar Kumar, M.B.B.S. [2]; Rim Halaby

Overview

Diastolic dysfunction, in the presence or absence of diastolic heart failure, is a challenging diagnosis that has several diagnostic approaches. While cardiac catheterization can be used to establish the diagnosis of diastolic dysfunction by the invasive measurement of elevated left ventricular end diastolic pressure and mean pulmonary capillary pressure, echocardiography provides an alternative noninvasive diagnostic tool.

Other Diagnostic Studies

Cardiac Catheterization

The predictors of the filling pressure and the degree of myocardial disease progression are essentially the mean pulmonary wedge pressure PCWP (which is equal to the mean left atrial pressure in the absence of mitral stenosis) and the left ventricular end diastolic pressure LVEDP.Cardiac Catheterization is an invasive diagnostic study that allows the measurement of the PCWP and LVEDP.

  • The diastolic phase of the cardiac cycle is normally characterized by rapid blood filling at low left ventricular pressures
  • The hallmark of diastolic dysfunction is elevated left ventricular end diastolic pressure or filling pressure
  • The cut off values used for the diagnosis of diastolic dysfunction are:
    • PCWP >12 mmHg
    • LVEDP> 16mmHg [1]

References

  1. Paulus WJ, Tschope C, Sanderson JE, Rusconi C, Flachskampf FA, Rademakers FE, et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J 2007;28: 2539-50.

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