Gerard P. Aurigemma MD

No Relevant Disclosures

Diastology:

2016 Guidelines

2 JASE 2016

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Slide ‘borrowed’ from Dr. Alan Klein, President, ASE

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7

•LV size and

shape

•Transmitral flow

• PV Doppler

•Tissue Doppler

•PA pressure

•LA size

The

Diastology

Toolbox

TDI: Directly Assesses LV

Relaxation

10

Animation from Steve Lester, Mayo Clinic

From Bouchard et al AJC 2008

68 year old with HCM and

intractable AF

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Key Variables: Diastolic

Function Guidelines

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Suggested Report

Conclusions

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52 year old

DOE

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4Ch

plane

optimi

zed

for LA

4Ch

plane

optim

ized

for

LV

2Ch view

SM

66 year old

Retired police officer

poorly controlled

hypertension

Feels just fine, thanks

LAVi 35 cc/M2

No TR jet

29 Nagueh JASE 2016

Depressed EF or Preserved EF + Heart

Disease

52 year old man history of CAD admitted with HF

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52 year old man history of CAD admitted with HF

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• E wave 120 cm/s

• DT 150 ms

• E>>A

• Average e’ 7.5 cm/s

• E/e’ 15

• D dominant PV

• B bump

• LAVi 33 ml/M2

38 Nagueh JASE 2016

Depressed EF or Preserved EF + Heart

Disease

MS

76 year old

Visiting family

Son notices that she is

coughing and very dyspneic

on exertion

ED: CHF; BNP 673

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42 Nagueh JASE in press

43 Nagueh JASE in press

Depressed EF or Preserved EF + Heart

Disease

44

63 year old

African immigrant

Hypertension history

Now has hypotension

weakness

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Summary

LVH

E/A indeterminate

E/e’=20

No TR jet

No LAE

47 Nagueh JASE 2016

Depressed EF or Preserved EF + Heart

Disease

48

63 year old

African immigrant

Hypertension history

Now has hypotension

weakness

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52 Dickey, Ogunsua et al JASE (in press)

Diastolic Function: why worry?

• Assess filling pressures, both high

and low

• Can lead to diagnosis of RCM

• Prognosis

• Understand pathophysiology of

heart disease

53

Diastolic Function: why worry?

• Assess filling pressures, both high

and low

• Can lead to diagnosis of RCM

• Prognosis

• Understand pathophysiology of

heart disease

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