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Studying diastology with speckle tracking echocardiography: The essentials.

Research paper by Arindam A Choudhury, Rohan R Magoon, Vishwas V Malik, Poonam Malhotra PM Kapoor, S S Ramakrishnan

Indexed on: 12 Jan '17Published on: 12 Jan '17Published in: Annals of cardiac anaesthesia



Abstract

Diastolic dysfunction is common in cardiac disease and an important finding independent of systolic function as it contributes to the signs and symptoms of heart failure. Tissue Doppler mitral early diastolic velocity (Ea) combined with peak transmitral early diastolic velocity (E) to obtain E/Ea ratio provides an estimate of the left ventricular (LV) filling pressure. However, E/Ea has a significant gray zone and less reliable in patients with preserved ejection fraction (>50%). Two-dimensional echocardiographic speckle tracking measure myocardial strain and strain rate (Sr) avoiding the Doppler-associated angulation errors and tethering artifacts. Global myocardial peak diastolic strain (Ds) and diastolic Sr (DSr) at the time of E and isovolumic relaxation combined with E (E/Ds and E/10 DSr) have been recently proposed as novel indices to determine LV filling pressure. The present article elucidates the methodology of studying diastology with strain echocardiography along with the advantages and limitations of the novel technique in light of the available literature.