This week we are kicking off the diastolic function guideline series, hosted by our guest blog writer Michael Owen! But first, we need to cover the basics on ‘how-to‘ acquire the measurements needed to evaluate for diastolic function.
The measurements needed to evaluate diastolic function include: pulsed-wave (PW) Doppler of mitral valve inflow, tissue Doppler imaging (TDI) and pulmonary veins, left atrial (LA) volume index, tricuspid regurgitation (TR) Doppler velocity and left ventricle (LV) ejection fraction (EF). Luckily, we have covered a few of these items in our past blogs!
The first group of measurements come from performing PW Doppler at the mitral valve leaflet tips. The following measurements can be obtained from this waveform:
Next we need to evaluate the septal and lateral e’ velocity using PW tissue Doppler imaging (TDI)! Using this, we can obtain the following measurements:
Lucky for you, we already posted a blog on correct tips to obtaining pulmonary vein Doppler waveform! You can review it here! The measurements needed from the pulmonary vein waveform for evaluation of diastolic function include:
We also need to evaluate the left atrium volume, indexed to BSA (LAVI)! We have a blog written on this already- you can check it out here!
You can view the blog over proper method to performing LV bi-plane measurement to determine volumes and ejection fraction here!
The last measurement we must have in order to evaluate for diastolic function is the tricuspid regurgitation (TR) velocity gradient! You can find out how-to guide from our right heart quantification blog series, here!
Now that we have covered the basic assessment of measurements, we’re ready to dive into how to apply these towards determining diastolic function!
Andrea Fields MHA, RDCS
Nagueh, S. F., MD, Smiseth, O. A., MD, & Appleton, C. P., MD. (2016). Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and European Association of Cardiovascular Imaging. American Society of Echocardiography, 29(4), 277-314. Retrieved October 31, 2017, from http://asecho.org/wordpress/wp-content/uploads/2016/03/2016_LVDiastolicFunction.pdf