Diastolic Dysfunction Flashcards
Normal medial E’
> =7
Normal lateral E’
> =10
Normal E/E’
Average <= 14
Medial <=15
Normal TR velocity
<=2.8 m/s
Normal LAVI
<=34
Normal IVRT
80-120 ms
Grade I IVRT
> 120 ms
Grade II IVRT
<80 ms
Grade III IVRT
<80 ms
Normal PV pattern
S>D
Grade I PV
S>D
Grade II PV
S < D
Grade III PV
S «_space;D
Normal E wave decal time
<= 258
Grade I decal time
> 258
Pseudonormal decel time
160-258
Restrictive decal time
<160
GLS predictor of cardiotox
Drop in GLS >15% or 3% absolute value
EF definition of cardiotoxicity
Drop in EF of 10% to value <53%
Tissue doppler filters
High velocities
Strain rate equation
SR = (V1-V2)/L
Negative radial strain
Relaxation if diastole
Dyskinesis if systole
Postive radial strain
Contraction
Torsion during isovolumic contraction
Apex clockwise
Base counterclockwise
Torsion during ejection
Apex counterclockwise
Base clockwise
E/e’ in diabetics
Correlates with A1c
Better predictor than EF in acute HF
GCS
Strain rate 0
akinesis
Strain rate >0
Expansion
Strain rate <0
Compression
Annulus paradoxus
E/e’ has reverse correlation with PCWP in constrictive pericarditis
Normal radial strain
40-60%
PV S1
changes in LA pressure, LA relaxation or contraction
PV S2
SV and pulse wave propagation in pulmonary tree
PV D
Changes in LV compliance and filling, changes with mitral E velocity
PV AR
LV late diastolic pressures, atrial preload, left atrial contractility
PV AF or atrial stunning
Blunted S (S1), absent AR
PV AR for elevated LV filling pressure
> 35
V waves in absence of MR
Decreased LA compliance
1st degree AVB and mitral inflow
May cause E-A fusion
L wave
Markedly delayed relaxation mid diastolic filling
LVEDP using AR
DBP - 4 end diastolic velocity ^2
PV AR > a wave by 30
high lvedp
HV S
Systolic forward flow
HV D
diastolic forward flow
HV SR
Systolic flow reversal
HV AR
Atrial flow reversal
Normal HV
S > D, no significant flow reversals
HV Myopathy
Flow reversals increased with inspiration
TR HV
prominent systolic reversal
CP HV
augmented diastolic flow reversal with expiration