1/5 My Dx for the E' Vel...
Highlights
- 1/5 My Dx for the e' velocity of 4 cm/s is reduced myocardial relaxation, which is sine qua non of diastolic dysfunction. It is present in all forms of myocardial disease and also with aging. Let me explain its progression & how to use the information for our pts MayoClinicCV
(View Tweet)
- 25 In young healthy ❤️, medial e' is > 10cm/s and ⬆️when more filling is needed with active suction at early diastole (E). With aging or myopathy, it gradually ⬇️ with reduced E, but atrial contraction compensates with E/A >= 7 cm/s, filling remains OK.
(View Tweet)
- 3/5 With further ⬇️ in relaxation ( medial e' < 7cm/s ), E ⬇️ & A ⬆️ with E/A < 0.8. In this Gr 1 DF, LVEDP may ⬆️, but mean LV diastolic pressure remains normal, but potential ⬆️ in FP with exercise, HFpEF. e' does not ⬆️ much with 🏌. This DF is also seen in compensated HF.
(View Tweet)
- 4/5 As LV compliance gets worse and LA pressure ⬆️, LV diastolic pressure (LVDP) ⬆️ rapidly with ⬆️ E. Due to ⬆️ in LVDP, atrial contraction (A)contributes a little, E/A > 0.8 - 2 (Gr 2) , > 2 (Gr 3), but PV atrial reversal ⬆️ Gr 3 DF
occurs most frequently in #amyloid or ⬇️ EF. (View Tweet)
- 5/5 Diastolic function assessment is critical for patient management AJamilTajik The best way to determine DF is to understand underlying physiology. More often than not, 2 parameters, mitral inflow and annulus velocity, are sufficient as shown below. #AIECG is also promising.
(View Tweet)