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Diastolic dysfunction: can it be diagnosed by Doppler echocardiography?

Mathew S Maurer1, Daniel Spevack, Daniel Burkhoff

  • 1Department of Medicine, College of Physicians and Surgeons, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA.

Journal of the American College of Cardiology
|October 19, 2004
PubMed

Insights

Heart failure with normal ejection fraction (HFNEF) is common in older women and linked to diastolic dysfunction. This study distinguishes Doppler measures from true ventricular diastolic function, questioning HFNEF

Area of Science:

  • Cardiology
  • Physiology

Background:

  • Heart failure with normal ejection fraction (HFNEF) predominantly affects older women.
  • It is often attributed to diastolic dysfunction.
  • Doppler echocardiography is the standard diagnostic tool for diastolic function.

Purpose of the Study:

  • To differentiate Doppler-derived measures of ventricular filling from intrinsic ventricular diastolic properties.
  • To compare Doppler echocardiography with pressure-volume analysis for assessing diastolic function.
  • To question the universal pathophysiologic mechanisms in HFNEF.

Main Methods:

  • Physiologic measures of intrinsic ventricular diastolic function were determined using pressure-volume analysis.
  • These measures were compared with those derived from Doppler echocardiography.

Main Results:

  • Doppler-derived indexes of ventricular filling do not specifically reflect intrinsic passive diastolic properties.
  • Abnormal filling dynamics do not necessarily indicate intrinsic myocardial diastolic dysfunction.

Conclusions:

  • A fundamental question is raised regarding the unifying pathophysiologic mechanisms in HFNEF.
  • Delayed relaxation and/or stiffened passive properties may not be universally present in all HFNEF patients.

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