Intro To Diastolic Function

Question 1

Compliance is defined as

Answer 1

Change in volume/change in pressure (Dv/Dp) in the LV during diastole

Question 2

The inverse of compliance

Answer 2

Stiffness

Question 3

Define the following MV Inflow Measurements:
E Point
DT
A point

Answer 3

E point- peak velocity in early filling
DT- deceleration time (how quickly the filling slows down)
A point- late filling peak velocity

Question 4

What is normal DT?

Answer 4

160-220 ms

Question 5

What is normal E/A ratio?

Answer 5

0.8-2.0

Question 6

Does diastolic dysfunction cause an increase in filling pressures?

Answer 6

No, an increase in filling pressures cause DDFxn

Question 7

What 3 factors affect early diastolic filling?

Answer 7

1. Preload
2. Hypo/hypervolemia
3. Excessive mitral regurgitation (Starling’s Law)

Question 8

What 5 factors affect late diastolic filling?

Answer 8

1. Cardiac rhythm
2. Atrial contractile function
3. Increased LVEDP
4. HR
5. Ventricular diastolic function

Question 9

Which plane is the velocity measured in TDI?

Answer 9

Longitudinal

Question 10

How to differentiate e prime and a prime?

Answer 10

E prime is right after s prime

Question 11

What is normal values for medial and lateral TDI?

Answer 11

Medial- >/= 8 cm/s
Lateral- >/= 10 cm/s

Question 12

How to calculate E/e prime ratio?

Answer 12

E velocity/e prime velocity

Question 13

What is normal E/e’ and what is abnormal with elevated filling pressures?

Answer 13

Normal <8
Abnormal with elevated filling pressures >14

Question 14

What are the values associated with diastolic dysfunction (TR and RVSP)

Answer 14

TR jet velocity >2.8m/sec
Or RVSP >30-40mmHg

Question 15

Why are LVH and LAE (LA enlargement) usually accompanied with diastolic dysfunction?

Answer 15

Because a thicker LV muscle is less compliant which leads to increased filling pressures which causes the LA size to increase and since the LA muscle is thin it will dilate under increased pressures