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Appendix C. Diastolic Function

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    AMA Citation
    Appendix C. Diastolic Function. In: Mathew JP, Swaminathan M, Ayoub CM. Mathew J.P., Swaminathan M, Ayoub C.M. Eds. Joseph P. Mathew, et al.eds. Clinical Manual and Review of Transesophageal Echocardiography, 2e New York, NY: McGraw-Hill; 2010. http://accessanesthesiology.mhmedical.com/content.aspx?bookid=417&sectionid=40109096. Accessed November 18, 2019.
    MLA Citation
    . "Appendix C. Diastolic Function." Clinical Manual and Review of Transesophageal Echocardiography, 2e Mathew JP, Swaminathan M, Ayoub CM. Mathew J.P., Swaminathan M, Ayoub C.M. Eds. Joseph P. Mathew, et al. New York, NY: McGraw-Hill, 2010, http://accessanesthesiology.mhmedical.com/content.aspx?bookid=417&sectionid=40109096.

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Normal

Impaired Relaxation

Pseudonormal

Restrictive Filling

TMF

E/A

1-2

<0.8

0.8-1.5

≥2

DT (ms)

150-220

>200

150-220

<160

IVRT (ms)

60-100

>100

>100

<60

PVF

PV-S/PV-D

>1

>1

<1

<1

PV-AR (cm/s)

<35

<35

>35

>35

ARdur–Adur

<30

<30

>30

>30

Vp

>55

<45

<45

<45

E′

>8 (septal)

>8 (septal)

<8 (septal)

<8 (septal)

>10 (lateral)

>10 (lateral)

<10 (lateral)

<10 (lateral)

E/E′

<8 (septal)

≤8 (septal)

9-12

>15 (septal)

<8 (lateral)

≤8 (lateral)

(average)a

>12 (lateral)

a Average of septal and lateral velocities. TMF, transmitral flow; E, early filling peak velocity; A, late-filling peak velocity; DT, deceleration time of E wave; IVRT, isovolumic relaxation time; PV-S, peak velocity of systolic component; PV-D, peak velocity of diastolic component; PV-AR, peak velocity of atrial reversal flow; PV-ARdur, duration of atrial reversal flow; Adur, duration of A wave; PVF, pulmonary venous flow; E′, peak tissue velocity in early diastole; Vp, velocity of propagation.

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Age Group (years)

Doppler Parameter

Measurement

<20

21-60a

>60

Transmitral low

IVRT (ms)

50 ± 9

67-74

87 ± 7

E/A ratio

1.9 ± 0.5

1.5-1.3

1.0 ± 0.2

DT (ms)

142 ± 19

166-181

200 ± 29

A dur (ms)

113 ± 17

127-133

138 ± 19

Pulmonary vein flow

S/D ratio

0.8 ± 0.18

1.0-1.2

1.4 ± 0.5

Ar (cm/s)

16 ± 10

21-23

25 ± 9

Ar dur (ms)

66 ± 39

96-112

113 ± 30

Lateral annulus tissue velocity

E′ (cm/s)

21 ± 3.8

20-16

13 ± 3.5

E′/A′ ratio

3.1

1.9-1.5

0.9 ± 0.4

Values are expressed as mean ± standard deviation. aFor the age group 21-60, values are expressed as range of means. A′, late lateral annulus tissue velocity; A, late transmitral velocity; Ar, pulmonary venous atrial reversal velocity; D, pulmonary venous diastolic velocity; DT, deceleration time; dur, duration; E′, early lateral annulus tissue velocity; E, early transmitral velocity; IVRT, isovolumic relaxation time; ms, milliseconds; S, pulmonary venous systolic velocity.

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1. Nagueh SF, Appleton CP, Gillebert TC, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J Am Soc Echocardiogr. 2009;22:107-133.  [PubMed: 19187853]

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