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J Am Soc Echocardiogr. 2019 Feb;32(2):216-232.e2. doi: 10.1016/j.echo.2018.11.011.

Pathophysiology and Echocardiographic Diagnosis of Left Ventricular Diastolic Dysfunction.

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Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address:


Echocardiography is the primary imaging modality used for the clinical evaluation of left ventricular (LV) diastolic function. Using two-dimensional together with transmitral, mitral annular, and pulmonary venous Doppler data, conclusions may be drawn regarding the relaxation and compliance properties of the ventricle that can be used for estimating LV filling pressure. Echocardiographic estimation of LV filling pressure has been shown to be especially useful for evaluating patients with dyspnea of unknown etiology as well as those with heart failure with preserved ejection fraction. Moreover, echocardiographic estimation of LV filling pressure can be used for clinical decision making on day-to-day basis. This article discusses the pathophysiology of diastolic dysfunction and provides a comprehensive review of its echocardiographic evaluation.


Diastolic function; HFpEF; Heart failure; Left ventricular filling pressure


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