Oxford Handbook of Clinical and Laboratory Investigation (Oxford Medical Handbooks) by Provan Drew

Author:Provan, Drew [Provan, Drew]
Language: eng
Format: epub
ISBN: 9780199233717
Publisher: Oxford University Press, USA
Published: 2010-07-15T00:00:00+00:00

Left ventricular diastolic function

Left ventricular filling during diastole is an important component of left ventricular functional assessment. Normal LAt filling is passive throughout systole (S wave) and diastole (D wave), and is assessed from pulse wave Doppler sampling of pulmonary venous flow. Left ventricular filling is assessed from diastolic mitral valve flow. It is predominantly passive and early in diastole (E wave), with a small, later contribution from atrial systole (A wave). Diastolic dysfunction results in elevated left ventricular end diastolic pressure (LVEDP) and ultimately left atrial pressure (LAP) and so alters measured flow characteristics. There are three types of diastolic dysfunction (Table 6.6), depending on the degree of raised LAP that occurs in order to drive flow across the mitral valve.

Table 6.6 Echo assessment of left ventricular diastolic dysfunction

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