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Mid-Diastolic Events (L Events): A Critical Review

Emanuele Di Virgilio1, Francesco Monitillo1, Daniela Santoro1

  • 1University Cardiology Unit, Polyclinic University Hospital, 70124 Bari, Italy.

Journal of Clinical Medicine
|December 10, 2021
PubMed

Insights

Mid-diastolic events, including L wave, indicate severe diastolic dysfunction and predict poor outcomes. Further research is needed to fully understand their mechanisms and significance.

Area of Science:

  • Cardiology
  • Echocardiography
  • Physiology

Background:

  • Mid-diastolic events (L events) encompass L wave, L motion, and L' wave, observed during diastasis.
  • L wave is a recognized indicator of advanced diastolic dysfunction in conditions like ventricular remodeling and cardiomyopathies.
  • L events are associated with adverse outcomes, including heart failure, arrhythmias, and sudden cardiac death.

Purpose of the Study:

  • To elucidate the pathophysiological mechanisms underlying mid-diastolic events.
  • To investigate the significance of L events in healthy individuals and at the tricuspid valve level.
  • To present a case study using speckle tracking imaging to explore L wave genesis.

Main Methods:

  • Echocardiography to assess mid-diastolic phenomena (L wave, L motion, L' wave).
  • Speckle tracking imaging of the left atrium and ventricle in a case study.
  • Review of current knowledge on mid-diastolic events.

Main Results:

  • L events are linked to poor patient outcomes and increased risk of heart failure and arrhythmias.
  • The exact genesis of mid-diastolic events remains incompletely understood.
  • A case study suggests a potential "two-step" ventricular relaxation mechanism for L wave.

Conclusions:

  • Mid-diastolic events are significant markers of diastolic dysfunction with prognostic implications.
  • Further research is warranted to clarify the mechanisms and clinical relevance of L events.
  • Understanding L events may improve diagnosis and management of cardiovascular diseases.

Keywords:
L wavediastasisdiastolic functionechocardiographyspeckle tracking imaging

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