Assessment of LV Diastolic Function by Echo in SR and AF

Echocardiographic assessment of left ventricular diastolic function with special reference on diastolic function assessment in atrial fibrillation. Though there are several parameters for evaluation of left ventricular diastolic function by echocardiography, the most commonly used are the pulsed Doppler mitral E/A ratio and tissue Doppler mitral E/e’ ratio. Some of the other useful parameters are mitral E velocity deceleration time, changes in mitral inflow with Valsalva maneuver, mitral L velocity, isovolumic relaxation time, left atrial maximum volume index, pulmonary vein systolic/diastolic velocity ratio, color M-mode Vp and E/Vp ratio. Tricuspid regurgitation jet velocity and pulmonary regurgitation end diastolic velocity indicating pulmonary hypertension are also taken as surrogates of left atrial pressure in the absence of pulmonary disease. Doppler interrogation of mitral valve is usually done from the apex through the apical four chamber view. The transducer is placed directly over the apex beat and the echo beam is directed upwards. A good four chamber view of the heart is obtained, showing all four chambers and both atrioventricular valves. The Doppler cursor is then aligned along the long axis of the left ventricle, passing through the mitral valve. The Doppler sample volume is placed just distal to the mitral valve so that it picks up the flow in the left ventricular inflow. The initial portion of the mitral diastolic flow is called the E wave (early diastolic)...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs