"Accurate" noninvasive detection of diastolic dysfunction by current techniques: fact or fancy?

To evaluate clinically left ventricular (LV) diastolic performance has been recognized in recent years to be an important part in cardiac evaluation, since diastolic abnormalities occur early and are sensitive indicators of diseased myocardium as well as determinants of cardiac output. Data on LV diastolic function are noninvasively acquired in recent years in most laboratories from: 1) radionuclide angiography, 2) echocardiography (M-mode and 2D) and 3) Doppler echocardiography. All these widely accepted and used methods for the detection and quantification of diastolic dysfunction are based on the assessment of indices of either rate of ventricular filling or rate of change of LV diameter and wall thickness during diastole.