In such instances, other diastology
parameters such as isovolumetric relaxation time (IVRT) or IVRT/[T.sub.E-e'] ratio are utilized to measure LAP.
The section on diastology
is brief, almost an afterthought, but is in keeping with the practical nature of the book, given that intraoperative decision-making is rarely altered by diastolic parameters.
(21), who performed a sub-study of PRIDE, reported on 139 of 599 patients who were referred for clinically indicated echocardiograms and found only modest correlations with indices of right and left ventricular structure, systolic function, and diastology
. The PRIDE analysis was limited by referral bias for echocardiography, but our data largely corroborate their findings and, in addition, did not reveal significant correlations with echocardiographic findings of increased left ventricular filling pressures in unselected dyspnea patients with mandated prospective echocardiograms and preserved LVEF.
"The bottom line is that we should be measuring the different parameters of diastolic function," agrees Cleveland Clinic cardiologist Allan Klein, MD, an expert on diastology. "We should measure filling pressure before the patient gets on the treadmill and after."
It's only been in recent years that diastology is becoming well understood, and this recent research supports the idea that diastolic dysfunction can be a key indicator of conditions such as HF.
Technical aspects of diastology
: why mitral inflow and tissue Doppler imaging are the preferred parameters?
The incidence of DHF is increasing and is especially common in older women with high blood pressure, says Cleveland Clinic cardiologist and Director of Cardiovascular Imaging Research Allan Klein, MD, a pioneer in the relatively new field of "diastology
With current knowledge of diastology
, it is now understood that verapamil actually caused worsening, restrictive LV diastolic dysfunction, increasing early velocities because of increased left atrial pressure.