Abstract
With the aging of society in Japan, the number of cases of heart failure with preserved left ventricular ejection fraction (HFpEF) has increased. Left ventricular (LV) diastolic dysfunction plays a central role in the pathogenesis of HFpEF. Thus, recognition and precise evaluation of LV diastolic function is essential for finding the optimal therapeutic strategy in HFpEF. Echocardiography with Doppler is useful for noninvasive assessment of LV diastolic dysfunction in the clinical setting. LV diastolic function is basically classified into the normal, abnormal relaxation, pseudo-normal, or restrictive pattern by trans-mitral flow with Doppler. Early-diastolic velocity of mitral annulus (e′) with tissue Doppler (TD) imaging is useful in demonstrating impaired LV relaxation and distinguishing the pseudo-normal or restrictive pattern from the normal pattern of trans-mitral flow. Pulmonary venous flow and left atrial volume are also useful for assessing LV diastolic function. However, all of these echocardiographic diastolic parameters have their limitations, and LV diastolic function should be assessed comprehensively using multiple parameters, not any single parameter. In addition, LV diastolic function declines with age even in healthy individuals. Thus, the individual’s age should be considered when assessing abnormalities of LV diastolic function. This review briefly provides the basics of how to assess LV diastolic function by echocardiography.
