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Echocardiography > Table 7.3 -Stages of Diastolic Dysfunction > Flashcards

Table 7.3 -Stages of Diastolic Dysfunction Flashcards

1
Q

What are the units of IVRT

A

Milliseconds

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2
Q

What are the values for:
Normal IVRT
Stage I (Impaired Relaxation)
Stage II (Pseudonormal)
Stage III (Reversible Restrictive Filling)
Stage IV (Irreversible Restrictive Filling)

A

Normal: 70-90
Stage I: >90
Stage II 60-90
Stage III <70

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3
Q

What are the Parameters of Diastolic Dysfunction?

A 
IVRT
E/A Ratio
 % change with Valsalva
Deceleration Time
e' (septum)
e' (lateral)
E/e' Ratio (septum)
E/e' Ratio (lateral) 
Pulmonary Venous Flow
-S/D
-Ar-A 
Propagation Velocity
LA Volume Index
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4
Q

What are the Values for Normal Diastolic Function?

A 
IVRT: 70-90ms
E/A Ratio: 0.9-1.5
 % change with Valsalva: both values decreased, ratio same.
Deceleration Time: 160-240ms
e' (septum): >10 cm/sec
e' (lateral): >12 cm/sec
E/e' Ratio (septum): 5-10 cm/sec
E/e' Ratio (averaged): -
Pulmonary Venous Flow
-S/D Ratio: S ≥ D
-Ar-A: < 0 ms
Propagation Velocity: >50 cm/sec
LA Volume Index: 16-28 mL/m2
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5
Q

What are the Values for Stage I Diastolic Dysfunction?

Impaired Relaxation

A 
IVRT: > 90ms 
E/A Ratio: < 0.9
Deceleration Time: >240ms
e' (septum): < 10 cm/sec
e' (lateral):  < 10 cm/sec
E/e' Ratio (septum): 
E/e' Ratio (averaged): < 8 cm/s
Pulmonary Venous Flow
-S/D Ratio: S > D
-Ar-A:  varies
Propagation Velocity: < 50 cm/sec
LA Volume Index: > 28 mL/m2
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6
Q

What are the Values for Stage II Diastolic Dysfunction?

Psuedonormal

A 
IVRT: 60-90ms 
E/A Ratio:  0.9-1.5
Deceleration Time: 140-200ms
e' (septum): < 8 cm/sec
e' (lateral):  < 8 cm/sec
E/e' Ratio (septum): 
E/e' Ratio (averaged): 9 -12 cm/s
Pulmonary Venous Flow
-S/D Ratio: S ≤ D
-Ar-A:  > 30ms
Propagation Velocity: < 50 cm/sec
LA Volume Index: > 28 mL/m2
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7
Q

What are the Values for Stage III Diastolic Dysfunction?
Restrictive Filling
Reversible

A 
IVRT: < 70ms 
E/A Ratio:  > 1.8
Deceleration Time: < 140ms
e' (septum): < 5 cm/sec
e' (lateral):  < 8 cm/sec
E/e' Ratio (septum): 
E/e' Ratio (averaged): > 15cm/s
Pulmonary Venous Flow
-S/D Ratio: S << D
-Ar-A:  > 30ms
Propagation Velocity: < 50 cm/sec
LA Volume Index: > 35 mL/m2
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8
Q

What are the Values for Stage IV Diastolic Dysfunction?
Restrictive Filling
Irreversible

A 
IVRT: < 70ms 
E/A Ratio:  > 2.0
Deceleration Time: < 130ms
e' (septum): < 5 cm/sec
e' (lateral):  < 8 cm/sec
E/e' Ratio (septum): 
E/e' Ratio (averaged): > 15cm/s
Pulmonary Venous Flow
-S/D Ratio: S << D
-Ar-A:  > 30ms
Propagation Velocity: < 50 cm/sec
LA Volume Index: > 35 mL/m2
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9
Q

What is the E/A Ratio for Stage I with Valsalva?

A

Both E and A decreased, Ratio unchanged

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10
Q

What is the E/A Ratio for Normal?

A

0.9 -1.5 (unit-less ratio)

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11
Q

What is the E/A Ratio for Stage l?

A

< 0.9

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12
Q

What is the E/A Ratio for Stage lI?

A

0.9-1.5

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13
Q

What is the E/A Ratio for Stage lII?

A

> 1.8

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14
Q

What is the E/A Ratio for Stage lV?

A

> 2.0

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15
Q

What is the E/A Ratio for Stage II with Valsalva?

A

E decreases, A increases, Ratio reverses

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16
Q

What is the E/A Ratio for Stage III with Valsalva?

A

Ratio decreases, but still >1

17
Q

What is the E/A Ratio for Stage IV with Valsalva?

A

No Response

18
Q

What is the E/A Ratio for Normal Diastolic Function with Valsalva?

A

Both E and A decreased, Ratio unchanged

19
Q

What is the DT for Normal Diastolic Function?

A

160-240ms

20
Q

What is the DT for Stage I?

A

> 240ms

21
Q

What is the DT for Stage II?

A

140-200ms

22
Q

What is the DT for Stage III?

A

<140ms

23
Q

What is the DT for Stage IV?

A

<130

24
Q

What is the LA Volume Index for both Stage III and Stage IV?

A

> 35 mL/m2

25
Q

What is the LA Volume Index for both Stage I and Stage II?

A

> 28 mL/m2

26
Q

What is the LA Volume Index for Normal Diastolic Function?

A

16-28 mL/m2

27
Q

At which stage does the Pulmonary Flow S/D relationship reverse?

A

Stage II

Pseudonormal

28
Q

What is the Normal E/e’ Ratio

A

5-10 cm/sec

29
Q

What is the Stage I, Impaired Relaxation E/e’ Ratio?

Averaged

A

< 8 cm/sec

30
Q

What is the Stage II, Pseudonormal E/e’ Ratio?

Averaged

A

9-12 cm/sec

31
Q

What is the Stage III Restrictive Filling (Reversible) E/e’ Ratio?
(Averaged)

A

> 15cm/sec

32
Q

What is the Stage IV Restrictive Filling (Irreversible) E/e’ Ratio?
(Averaged)

A

> 15cm/sec

Echocardiography (5 decks)

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