The diastolic function: an echocardiographic study and its clinical meaning

Many patients with manifestations and/or symptoms of heart failure show a normal or only slight depressed systolic function of the left ventricle. The origin of these symptoms is attributed to anomalies of the diastolic function and the echocardiography has became an important technique for a non-invasive investigation of such anomalies. The valuation of the diastolic function, mainly in patients with a left ventricle dysfunction, is usually performed by means of the analysis of the transmitral flow with pulsed Doppler, integrating as necessary the basal information with actions of preload variations. However, in many cases it is necessary to use other procedures of study to better characterise the diastolic function in each patient by means of the analysis of venous pulmonary flow, the valuation of propagation velocity of mitral flow with Color M-Mode, or the valuation of diastolic velocities of myocardium with Doppler tissue imaging. The integrated analysis of these various methods of exam, moreover, allows to enhance the diagnostic accuracy in the evaluation of the filling pressure, which is a fundamental parameter to stratify the risk of short/medium term events, being equal the left ventricle dysfunction.