TY - JOUR
T1 - Canadian consensus recommendations for the measurement and reporting of diastolic dysfunction by echocardiography
T2 - from the Investigators of Consensus on Diastolic Dysfunction by Echocardiography.
AU - Rakowski, H.
AU - Appleton, C.
AU - Chan, K. L.
AU - Dumesnil, J. G.
AU - Honos, G.
AU - Jue, J.
AU - Koilpillai, C.
AU - Lepage, S.
AU - Martin, R. P.
AU - Mercier, L. A.
AU - O'Kelly, B.
AU - Prieur, T.
AU - Sanfilippo, A.
AU - Sasson, Z.
AU - Alvarez, N.
AU - Pruitt, R.
AU - Thompson, C.
AU - Tomlinson, C.
N1 - Funding Information:
Abnormalities of diastolic filling are increasingly recognized as a cause of symptoms and predictors of outcome in patients with most forms of heart disease. Noninvasive assessment of diastolic filling is possible in almost all patients, but accurate evaluation must relate echocardiographic Doppler measurements to the complex physiologic and hemodynamic factors responsible for normal and abnormal filling. This evaluation has been facilitated by recent correlation of Doppler measurement of mitral and pulmonary venous inflow with hemodynamic studies. These studies have confirmed that when a careful, integrated approach is taken, Doppler flow patterns can document a progressive pattern of abnormality in many conditions. Impaired left ventricular (LV) relaxation is seen early and is recognized by a decrease in early transmittal LV filling and an increased proportion of filling during atrial contraction. As abnormalities progress, increasing LV chain- There is an evolving body of evidence that abnormalities of diastolic filling play an important role in the clinical status and prognosis of patients with most forms of heart disease) -~s In conditions such as hypertension, abnormalities of diastolic function may be detected before the clinical manifestations of disease. ~9'2° Left ventricular (LV) filling abnormalities have been demonstrated in patients with coronary artery disease with or without systolic dysfunction, z'3z'l°'t7,~s hypertension, t9"2° valvular disease, t° cardiomyopathies, 9a°'~2-~8 diabetes mellitus, 2~ and a variety of other systemic diseases. 22-25 In extreme conditions, congestive heart failure caused by dia- From the Investigators of Consensus on Diastolic Dysfimctionb y Echocardiography. Supported in part by an educational grant from Searle Canada. Reprint requests: Harry Rakowski, MD, The Toronto Hospital, 200 Elizabeth St., Toronto, Ontario, Canada M5G, 2C4. Copyright © 1996 by the AmericanS ocietyo f Echocardiography. 0894-7317/96 $5.00 + 0 27/1/68951
PY - 1996
Y1 - 1996
N2 - Abnormalities of diastolic filling are increasingly recognized as a cause of symptoms and predictors of outcome in patients with most forms of heart disease. Noninvasive assessment of diastolic filling is possible in almost all patients, but accurate evaluation must relate echocardiographic Doppler measurements to the complex physiologic and hemodynamic factors responsible for normal and abnormal filling. This evaluation has been facilitated by recent correlation of Doppler measurement of mitral and pulmonary venous inflow with hemodynamic studies. These studies have confirmed that when a careful, integrated approach is taken, Doppler flow patterns can document a progressive pattern of abnormality in many conditions. Impaired left ventricular (LV) relaxation is seen early and is recognized by a decrease in early transmitral LV filling and an increased proportion of filling during atrial contraction. As abnormalities progress, increasing LV chamber stiffness and elevated left atrial pressure lead to a "pseudonormal" filling pattern that previously has caused considerable confusion. This can be unmasked by careful evaluation of pulmonary venous inflow and the use of the Valsalva maneuver. When marked diastolic abnormalities are present, LV filling has restrictive features characterized by rapid early filling, a very stiff left ventricle with high filling pressures, and a poor prognosis. Routine measurement of indexes of diastolic filling have been hampered by uncertainty as to what should be measured, what techniques should be used, definition of normal values, and a clear method of reporting findings. This report represents the efforts of a Canadian consensus group to define a national standard for the performance and reporting of echocardiographic Doppler studies of diastolic filling.
AB - Abnormalities of diastolic filling are increasingly recognized as a cause of symptoms and predictors of outcome in patients with most forms of heart disease. Noninvasive assessment of diastolic filling is possible in almost all patients, but accurate evaluation must relate echocardiographic Doppler measurements to the complex physiologic and hemodynamic factors responsible for normal and abnormal filling. This evaluation has been facilitated by recent correlation of Doppler measurement of mitral and pulmonary venous inflow with hemodynamic studies. These studies have confirmed that when a careful, integrated approach is taken, Doppler flow patterns can document a progressive pattern of abnormality in many conditions. Impaired left ventricular (LV) relaxation is seen early and is recognized by a decrease in early transmitral LV filling and an increased proportion of filling during atrial contraction. As abnormalities progress, increasing LV chamber stiffness and elevated left atrial pressure lead to a "pseudonormal" filling pattern that previously has caused considerable confusion. This can be unmasked by careful evaluation of pulmonary venous inflow and the use of the Valsalva maneuver. When marked diastolic abnormalities are present, LV filling has restrictive features characterized by rapid early filling, a very stiff left ventricle with high filling pressures, and a poor prognosis. Routine measurement of indexes of diastolic filling have been hampered by uncertainty as to what should be measured, what techniques should be used, definition of normal values, and a clear method of reporting findings. This report represents the efforts of a Canadian consensus group to define a national standard for the performance and reporting of echocardiographic Doppler studies of diastolic filling.
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U2 - 10.1016/S0894-7317(96)90076-0
DO - 10.1016/S0894-7317(96)90076-0
M3 - Article
C2 - 8887883
AN - SCOPUS:0030227433
VL - 9
SP - 736
EP - 760
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
SN - 0894-7317
IS - 5
ER -