Ventricular diastolic function Flashcards
What does diastolic dysfunction frequently occur before?
systolic dysfunction
When is diastole on the ECG?
between the end of the T wave and the peak of the R wave
What does the duration of diastasis depend on?
HR
is longer is a slow HR and can be absent with a fast HR
List the parameters of diastolic function
- ventricular relaxation
- myocardial/chamber compliance
- filling pressures (can change based on pathology)
-also: elastic recoil of ventricle, and pericardial constraint
Describe abnormal ventricular relaxation
prolonged IVRT
slower rate of decline in ventricular pressure
reduced early peak filling rate
What factors can affect IVRT?
internal or external loading forces
inactivation of myocardial contraction
What does a more compliant ventricle allow?
allows more blood volume (vise versa)
How can compliance be defined?
ratio of change in volume to change in pressure
stiffness is the inverse
What are some factors that affect peak early diastolic filling rate?
changes in preload that affect the initial pressure difference between the ventricles and the atria (increased with volume loading, vise versa)
change in transmitral flow rate
change in atrial pressures
What are some factors than can affect late diastolic filling?
cardiac rhythm and rate
atrial contractile function and timing of contraction
ventricular end diastolic pressures
ventricular diastolic function
What do elevations in ventricular diastolic pressures affect?
(pressures where?)
pressures in the atria
What affects RA filling patterns?
What results in an absent atrial reversal?
respiratory variations
nonsinus cardiac rhythm
What do patients with pericardial disease have in RV and LV diastolic filling?
exaggerated respiratory phases
What is the normal velocity range for the mitral E wave?
A velocity?
.6-1.3m/s
.2-.7m/s
In the mitral valve waveform, what is a normal deceleration slope? deceleration time?
4.3-6.7m/s
140-200ms
