| Diastolic dysfunction: improved understanding using emerging imaging techniques. | |
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MedLine Citation:
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PMID: 20826245 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Diastolic heart failure is increasing in prevalence. Although the pathophysiology is incompletely understood and current therapeutic strategies are limited, identification of diastolic dysfunction is important. We review the role of contemporary techniques with echocardiography and cardiac magnetic resonance imaging (CMRI) in the assessment of diastolic dysfunction. Cardiac catheterization is the criterion standard for demonstrating impaired relaxation and filling by making direct measurements; however, echocardiography has replaced it as the most clinically used tool. By evaluating mitral inflow pulsed-wave Doppler with and without the Valsalva maneuver, isovolumetric relaxation time, pulmonary venous flow Doppler, color M-mode velocity propagation, tissue Doppler imaging, and speckle tracking, echocardiography is considered an accurate method for diagnosis and grading diastolic dysfunction. Evaluation of diastolic function can also be performed by CMRI. Mitral valve inflow velocities, early deceleration time, and pulmonary vein flow velocities are diastolic parameters that can be measured by phase-contrast CMRI. Cardiac magnetic resonance imaging steady-state gradient echo can evaluate functional dimensions for time-volume curves; and myocardial tagging can assess ventricular diastolic "untwisting," which may be important for improved pathophysiologic understanding. Studies have compared echocardiography and CMRI for diagnosing diastolic dysfunction in small patient groups with similar results. Cardiac magnetic resonance imaging can now provide clinically relevant data regarding the underlying cause of diastolic dysfunction and offers promise to gain mechanistic insights for therapeutic strategy development and clinical trial planning. |
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Authors:
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Daniel Daneshvar; Janet Wei; Kirsten Tolstrup; Louise E J Thomson; Chrisandra Shufelt; C Noel Bairey Merz |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: American heart journal Volume: 160 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-09 Completed Date: 2010-11-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 394-404 Citation Subset: AIM; IM |
Copyright Information:
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2010 Mosby, Inc. All rights reserved. |
Affiliation:
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Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aging
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physiology Echocardiography / methods Echocardiography, Doppler, Pulsed* Heart Catheterization Heart Failure, Diastolic / diagnosis*, physiopathology, ultrasonography* Humans Image Enhancement Magnetic Resonance Imaging, Cine* / methods Mitral Valve / physiopathology, ultrasonography Pulmonary Circulation / physiology Stroke Volume / physiology Valsalva Maneuver / physiology Ventricular Dysfunction, Left / physiopathology Ventricular Pressure / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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