Analysis of left ventricular diastolic function

Left ventricular diastolic function is a broad term which refers to a group of complex processes which interact to determine the resistance to filling of the left ventricle. Impairment in one or more of these processes may increase the resistance to filling and result in the need for raised filling pressures to maintain filling and cardiac output. Because of its complex and multifactorial nature 'diastolic function' is difficult to assess in patients. Doppler echocardiography has emerged as a powerful non-invasive tool to assess the characteristics of left ventricular filling, producing insight into diastolic function and its effect on filling pressures. This section will review the multiple interrelated factors which affect diastolic function and how Doppler echocardiography can be used to assess diastolic filling of the left ventricle. The interpretation of the various Doppler filling velocity curves as well as the practical utility of Doppler in the assessment of filling pressures and prognosis will be discussed.