Diastolic function

Question 1

define diastole

Answer 1

• phase of the heart cycle where chambers relax and fill with blood under low pressure. From AV closure to MV closure

Question 2

compliance

Answer 2

change in volume/change in pressure

Question 3

what is compliance inverse to?

Answer 3

stiffness

Question 4

stiffness

Answer 4

change in pressure/change in volume

Question 5

IVRT

Answer 5

period between AV closure & MV open

• LV pressure falling
• 50-100ms

Question 6

Early filling

Answer 6

150-200ms

- between MV open and diastasis

Question 7

which phase of diastole may be absent with AFIB?

Answer 7

late filling - atrial contraction

Question 8

what do the LV filling pressures include?

Answer 8

• LVEDP

- mean LAP

Question 9

what does an increase i LAEDP and LAP do to the LA?

Answer 9

dilate

Question 10

how thick is the LA

Answer 10

2-3mm

Question 11

CAD causes of DD

Answer 11

ischemia, infarct

Question 12

secondary hypertrophy (changes to heart muscle are adaptations to another disease) examples

Answer 12

HTN
aortic stenosis
severe MR

Question 13

primary myocardial disease examples

Answer 13

dilated cmo
infiltrative myocardial disease
hypertrophic cmo

Question 14

normal E/A

Answer 14

0.8-2

Question 15

normal DT

Answer 15

150-200

Question 16

mild DD

Answer 16

• reduced E/A
• reduced E
• prolonged DT
• reduced TDI
• E/e <14 (not increased)
• TR jet <2.8 still normal
• mild SOB on exertion

Question 17

grade 2 or psuedo normal DD

Answer 17

• impaired relaxation
• MV pattern looks normal
• E/e prime 10-14 (abn)
• MV A wave duration shortens as LAP increases
• everything else looks normal
• SOB at lower levels of activity
• get them to do valsalva to reduce venous return
• E wave will reduce <50% if positive

Question 18

which DD do you see an L wave with in the MV inflow trace?

Answer 18

grade 2 DD

increase LAP

Question 19

grade 3 DD

Answer 19

• increased E vel
• INCREASED E/A >2
• short DT
• increased E/e prime >14
• Tall E wave, short DT, increased LAP

Question 20

when is flow reversed in the pulmonary veins?

Answer 20

atrial systole

Question 21

three things that happen with DD

Answer 21

• PV atrial reversal wave increases velocity
• PV atrial reversal wave increases duration
• MV a wave decreases duration