Liaqat Ali, Abdul Rehman Abid, Muhammad Tahir Mohyuddin, Muhammad Azhar.
Echocardiographic evaluation of patients with diastolic dysfunction.
Pak J Cardiol Jan ;16(3):143-8.

Background: Diastolic heart failure is characterized by the presence of heart failure with preserved left ventricular systolic function. Diastolic dysfunction can be documented non-invasively by Doppler echocardiography. We designed this study to evaluate the role of echocardiography in diastolic dysfunction. Setting: This study was conducted at Cardiology Department of Mayo Hospital Lahore from January 1998 to September 1998. Study Design: This was a prospective observational study. Methods: During the study period one hundred consecutive patients having abnormal E/A ratio on echocardiography were studied. Detailed echocardiographic examination of all patients included in this study was done with a view to measure E/A, DT, IVRT, S and D waves, AR amplitude and width and S/D ratio. Results: Majority of the patients were in NYHA class I and II. On echocardiographic examination ejection fraction was normal in 54(54%) while it was less than 40% in 24% of patients. This correlates with NYHA class of the study population. Mean of peak E was 115±38 m.sec, mean of peak A was 66±23 m.sec. E/A ratio was 0.98±0.32. Mean DT was 157±72 and mean IVRT was 109±37 m.sec. Majority of patients 66(66%) patient had grade I diastolic dysfunction with reverse E / A ratio while only 16(16%) had grade II diastolic dysfunction and 18 (18 %) patients had restrictive pattern (Grade III diastolic dysfunction). This correlates with pattern of S and D components measured at pulmonary vein as D was >>S in 18 (18%) patients. S was >> D in 66 (66%) patients and S and D were equal or of normal pattern in 16 (16%) patients. Conclusion: Doppler echocardiography is a reliable noninvasive tool for the diagnosis of diastolic dysfunction and for evaluation of its severity in patients with or without overt congestive heart failure.

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