Diastology

Question 1

How many phases are there in Diastole? What are they called?

Answer 1

• 4 phases

- Isovolumic Relaxation, Early Rapid Filling, Diastasis, Atrial Systole (Atrial Kick)

Question 2

Isovolumic Relaxation (IVRT)

Answer 2

All 4 valves are closed
No blood is flowing
Begins when semilunar valves close, ends when AV valves open
Atrial Pressure rises slightly above Ventricular pressure, causing AV Valves to open

Question 3

Early Rapid Filling

Answer 3

Blood is passively flowing from the atrium to the ventricle due to atrial pressure being higher than ventricular pressure. Ventricle is relaxed/not contracting

Question 4

Diastasis

Answer 4

Active ventricular relaxation is completed and near equilibration of LA and LV pressures. Also, pulmonary vein flow continues to slowly refill the LA

Question 5

Atrial Kick/Atrial Systole

Answer 5

The LA squeezes the blood from the LA into the LV increasing the trans-mitral pressure gradient.

Question 6

What are the methods used for assessing Diastolic Function?

Answer 6

• Mitral Inflow/Transmitral Flow
• Mitral Annular E’ (tissue movement)
• Isovolumic Relaxation Time
• Pulmonary Vein Flow
• LA Size
• Tricuspid Regurgitation
• Propagation Velocity

Question 7

What is being measured in Mitral Inflow/Transmitral Flow? Method Used?

Answer 7

• Measured using Pulsed Doppler
• Measures blood flow through the mitral valve during early rapid filling (E wave) and atrial kick (A Wave)
• Measures Deceleration Time of early filling
• A wave Duration
• E/A, which should be just greater than 1.

Question 8

Answer 8

Pulse Doppler of Mitral Inflow

Question 9

Answer 9

Provides a measurement of the time for pressure equalization between the LV and LA
Measured in Mitral Inflow Pulse Doppler

   Normal Diastolic Parameter Decel Time:
                       DT (decel time) < 220 ms

Question 10

Answer 10

A-wave duration

measuring how long atrial kick/atrial systole lasts