Canadian consensus recommendations for the measurement and reporting of diastolic dysfunction by echocardiography: from the Investigators of Consensus on Diastolic Dysfunction by Echocardiography.

H. Rakowski, C. Appleton, K. L. Chan, J. G. Dumesnil, G. Honos, J. Jue, C. Koilpillai, S. Lepage, R. P. Martin, L. A. Mercier, B. O'Kelly, T. Prieur, A. Sanfilippo, Z. Sasson, N. Alvarez, R. Pruitt, C. Thompson, C. Tomlinson

Research output: Contribution to journalArticle

521 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)736-760
Number of pages25
JournalJournal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
Volume9
Issue number5
DOIs
StatePublished - Jan 1 1996
Externally publishedYes

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Echocardiography
Research Personnel
Hemodynamics
Valsalva Maneuver
Lung
Atrial Pressure
Uncertainty
Heart Ventricles
Heart Diseases
Reference Values
Pressure

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Canadian consensus recommendations for the measurement and reporting of diastolic dysfunction by echocardiography : from the Investigators of Consensus on Diastolic Dysfunction by Echocardiography. / Rakowski, H.; Appleton, C.; Chan, K. L.; Dumesnil, J. G.; Honos, G.; Jue, J.; Koilpillai, C.; Lepage, S.; Martin, R. P.; Mercier, L. A.; O'Kelly, B.; Prieur, T.; Sanfilippo, A.; Sasson, Z.; Alvarez, N.; Pruitt, R.; Thompson, C.; Tomlinson, C.

In: Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, Vol. 9, No. 5, 01.01.1996, p. 736-760.

Research output: Contribution to journalArticle

Rakowski, H, Appleton, C, Chan, KL, Dumesnil, JG, Honos, G, Jue, J, Koilpillai, C, Lepage, S, Martin, RP, Mercier, LA, O'Kelly, B, Prieur, T, Sanfilippo, A, Sasson, Z, Alvarez, N, Pruitt, R, Thompson, C & Tomlinson, C 1996, 'Canadian consensus recommendations for the measurement and reporting of diastolic dysfunction by echocardiography: from the Investigators of Consensus on Diastolic Dysfunction by Echocardiography.', Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, vol. 9, no. 5, pp. 736-760. https://doi.org/10.1016/S0894-7317(96)90076-0
Rakowski, H. ; Appleton, C. ; Chan, K. L. ; Dumesnil, J. G. ; Honos, G. ; Jue, J. ; Koilpillai, C. ; Lepage, S. ; Martin, R. P. ; Mercier, L. A. ; O'Kelly, B. ; Prieur, T. ; Sanfilippo, A. ; Sasson, Z. ; Alvarez, N. ; Pruitt, R. ; Thompson, C. ; Tomlinson, C. / Canadian consensus recommendations for the measurement and reporting of diastolic dysfunction by echocardiography : from the Investigators of Consensus on Diastolic Dysfunction by Echocardiography. In: Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography. 1996 ; Vol. 9, No. 5. pp. 736-760.
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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.

PY - 1996/1/1

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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.

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