Echokardiografia (Diastolická funkcia a dysfunkcia)

Apical 4 chamber (A4C). Mitral valve PW doppler

E-wave

Peak velocity in early diastole (Passive flow)

Maximálna rýchlosť prúdu počas skorej diastoly ľavej komory.
Slúži na výpočet MV E/A, MV E/e´, Lateral E/e´, E/Vp_colorM
A4C (Apikálna 4-dutinová projekcia).
Skorá diastola (EKG: Koniec T vlny).
PW doppler.

Kurzor sa umiestni medzi cípy mitrálnej chlopne.
Color doppler (pomôže pri identifikácii prúdu).

A-wave

Peak velocity in late diastole (Atrial contraction)

Maximálna rýchlosť prúdu počas neskorej diastoly ľavej komory (systola predsiení).
Slúži na výpočet MV E/A
A4C (Apikálna 4-dutinová projekcia).
Neskorá diastola (EKG: Tesne po P vlne).
PW doppler.

Kurzor sa umiestni medzi cípy mitrálnej chlopne.
Color doppler (pomôže pri identifikácii prúdu).

MV E/A

Mitral valve E-wave/A-wave ratio

MV E/A = E-wave / A-wave
Pomer E-wave a A-wave.
Je základný parameter pri vyšetrovaní diastolickej funkcie.

Valsalvov manéver

Valsalva maneuver

Nahráva sa 10s záznam na ktorom je zachytený

hlboký nádych a úsilný výdych proti zapchatému nosu.

Počas úsilného výdychu sa sleduje zmena:

E-wave
MV E/A (zmena ≥50% svedčí pre diastolickú dysfunkciu)

Apical 4 chamber (A4C). Lateral mitral annulus, pulsed tissue doppler (TDI)

Lateral e´

Lateral mitral annulus velocity (Early diastole)

Maximálna rýchlosť laterálneho mitrálneho annulu počas skorej diastoly ľavej komory.
Slúži na výpočet Average e´, Lateral E/e´
A4C (Apikálna 4-dutinová projekcia).
Skorá diastola (EKG: Koniec T vlny).
Pulsed tissue Doppler.

Kurzor sa umiestni na laterálny mitrálny annulus.

Apical 4 chamber (A4C). Septal mitral annulus, pulsed tissue doppler (TDI)

Septal e´

Septal mitral annulus velocity (Early diastole)

Maximálna rýchlosť septálneho mitrálneho annulu počas skorej diastoly ľavej komory.
Slúži na výpočet Average e´
A4C (Apikálna 4-dutinová projekcia).
Skorá diastola (EKG: Koniec T vlny).
Pulsed tissue Doppler.

Kurzor sa umiestni na septálny mitrálny annulus.

Average e´

Average e´= (Lateral e´+ Septal e´) / 2
Priemerná hodnota laterálnej a septálnej e´ vlny
Slúži na výpočet MV E/e´

MV E/e´

Mitral valve E-wave / Average e´ ratio

MV E/e´= E-wave / Average e´
Pomer E-wave a Average e´

Apical 4 chamber (A4C). Tricuspid valve CW doppler

Vmax TR

Peak tricuspid regurgitation systolic jet velocity

Maximálna rýchlosť trikuspidálnej regurgitácie.
A4C (so zameraním na pravú komoru).
Systola (EKG: R kmit - koniec T vlny)
CW doppler

Kurzor sa umiestni medzi cípy trikuspidálnej chlopne.
Color doppler (pomôže pri identifikácii prúdu).

Apical 4 chamber (A4C) focused left atrium

LA volume

Left atrial volume (Biplane)

Objem ľavej predsiene.
A4C (Apikálna 4-dutinová projekcia) a A2C (Apikálna 2-dutinová projekcia).
End systola (EKG: koniec T vlny).
Meria sa pomocou bi-plante metódy diskov (Simpson bi-plane).

V každej projekcii (A4C, A2C) sa opíše kontúra endokardu.
Echoprístroj potom vypočíta objem predsiene z dvoch projekcií.

Vypočítate ho v menu: Presiene a VCI

Lateral E/e´

MV E-wave / Lateral e´ ratio

Lateral E/e´= E-wave / Lateral e´
Pomer E-wave a laterálnej e´ vlny

MV DT

Mitral valve deceleration time

Deceleračný čas mitrálnej chlopne (E-wave).

Čas od maximálnej rýchlosti skorého plnenia (E-wave)
po zastavenie prúdu E-wave na 0cm/s.

A4C (Apikálna 4-dutinová projekcia).
Skorá diastola (EKG: Koniec T vlny).
PW doppler.

Kurzor sa umiestni medzi cípy mitrálnej chlopne.
Color doppler (pomôže pri identifikácii prúdu).

A4C (Apical 4 chamber view) LA pulmonary veins focus, systole, PW doppler

PV S wave

Pulmonary vein peak velocity (Early systole)

Maximálna rýchlosť prúdu v pulmonálnej véne pri plnení predsiene (počas systoly komôr).
Slúži na výpočet PV S/D ratio
A4C (so zameraním na pulmonálne vény).
Systola (EKG: R kmit - koniec T vlny)
PW doppler

Kurzor sa umiestni 1-2cm do pravej (alebo ľavej) pulmonálnej vény.
Color doppler (pomôže pri identifikácii prúdu).

A4C (Apical 4 chamber view) LA pulmonary veins focus, diastole, PW doppler

PV D wave

Pulmonary vein peak velocity (Early diastole)

Maximálna rýchlosť prúdu v pulmonálnej véne pri plnení predsiene (počas diastoly komôr).
Slúži na výpočet PV S/D ratio
A4C (so zameraním na pulmonálne vény).
Diastola (EKG: Koniec T vlny - R kmit)
PW doppler

Kurzor sa umiestni 1-2cm do pravej (alebo ľavej) pulmonálnej vény.
Color doppler (pomôže pri identifikácii prúdu).

PV S/D ratio

Pulmonary vein S/D wave ratio

PV S/D ratio = PV S wave / PV D wave
Pomer PV S wave a PV D wave.

PV S VTI

Pulmonary vein S wave velocity time integral

Velocity time integral pulmonálnej S vlny
Slúži na výpočet PV_sys.fraction
A4C (so zameraním na pulmonálne vény).
Systola (EKG: R kmit - koniec T vlny)
PW doppler

Kurzor sa umiestni 1-2cm do pravej (alebo ľavej) pulmonálnej vény.
Color doppler (pomôže pri identifikácii prúdu).

Total PV VTI

Total pulmonary vein inflow velocity time integral

Velocity time integral celkového (inflow) prúdu pulmonálnej vény
Slúži na výpočet PV_sys.fraction
A4C (so zameraním na pulmonálne vény).
Systola a diastola (EKG: R kmit - R kmit)
PW doppler

Kurzor sa umiestni 1-2cm do pravej (alebo ľavej) pulmonálnej vény.
Color doppler (pomôže pri identifikácii prúdu).

PV_sys.fraction

Pulmonary vein systolic filling fraction

PV_sys.fraction = PV S VTI / Total PV VTI x 100
Systolická frakcia pulmonálnej vény.

PV AR_duration

Pulmonary vein atrial reversal flow duration

Čas reverzného prúdu v pľúcnej véne počas systoly predsiene.
Slúži na výpočet AR-A
A4C (Apikálna 4-dutinová projekcia).
Systola predsiení (EKG: Tesne po P vlne)
PW doppler

Kurzor sa umiestni 1-2cm do pravej (alebo ľavej) pulmonálnej vény.
Color doppler (pomôže pri identifikácii prúdu).

MV A_duration

Mitral valve A-wave duration

Trvanie A-wave (A vlna informuje o systole predsiení).
Slúži na výpočet AR-A
A4C (Apikálna 4-dutinová projekcia).
Neskorá diastola (EKG: Tesne po P vlne).
PW doppler.

Kurzor sa umiestni tesme medzi cípy mitrálnej chlopne.
Color doppler (pomôže pri identifikácii prúdu).

AR-A

Time difference (PV AR_duration - MV A _duration)

AR-A = PV AR_duration - MV A_duration
Rozdiel časov: PV AR_duration - MV A _duration
AR-A duration >30 ms svedčí pre zvýšený LVEDP (left ventricular end-diastolic pressure).

L wave

Transmitral flow during diastasis

Prúd krvi z pľúcnych žíl cez predsieň do ľavej komory.
Je znak zvýšeného tlaku v ľavej predsieni.
Mid-diastola (EKG: Začiatok P vlny)
A4C (Apikálna 4-dutinová projekcia).
PW doppler.

Kurzor sa umiestni tesme medzi cípy mitrálnej chlopne.

Apical 4 chamber (A4C). Mitral valve M mode (MM)

Vp_colorM

Transmitral flow propagation velocity (Color Doppler M-mode)

Rýchlosť prúdu od bázy ľavej komory ku apexu v skorej diastole (čo koreluje s E vlnou).

Od bázy 4cm ku apexu.

Slúži na výpočet E/Vp_colorM
A4C (Apikálna 4-dutinová projekcia).
Skorá diastola (EKG: Koniec T vlny).
Color doppler

Nyquist limit (Aliasing) cca 30cm/s

M-mode

Kurzor sa umiestni medzi cípy mitrálnej chlopne.

Meria sa 4cm krivka na hranici aliasingu

od mitrálneho annulu smerom ku apexu.

E/Vp_colorM

E wave and transmitral flow propagation velocity ratio

E/Vp_colorM = E-wave / Vp_colorM
Pomer rýchlosti E vlny a transmitrálnej propagácie rýchlosti.
E/Vp_colorM koreluje s tlakom v ľavej predsieni.
E/Vp_colorM ≥2,5 predikuje PCWP > 15mmHg.

PCWP (Pulmonary capillary wedge pressure, Pľúcny kapilárny tlak v zaklínení)

AccR_{E wave}

Peak acceleration rate of mitral inflow E wave

Zrýchlenie E vlny
A4C (Apikálna 4-dutinová projekcia).
Skorá diastola (EKG: Koniec T vlny).
PW doppler.

Kurzor sa umiestni medzi cípy mitrálnej chlopne.
Color doppler (pomôže pri identifikácii prúdu).

PV DT_{D wave}

Deceleration time of pulmonary venous diastolic velocity

Čas od maximálnej rýchlosti D vlny po zastavenie prúdu D vlny na 0cm/s.
D vlna (prúd v pulmonálnej véne pri plnení predsiene v diastole komôr)
A4C (so zameraním na pulmonálne vény).
Diastola (EKG: Koniec T vlny - R kmit)
PW doppler

Kurzor sa umiestni 1-2cm do pravej (alebo ľavej) pulmonálnej vény.
Color doppler (pomôže pri identifikácii prúdu).

IVRT

Isovolumic Relaxation Time

Čas medzi uzavretím aortálnej a otvorením mitrálnej chlopne.
Slúži na výpočet IVRT/T_T-e´
A5C (Apikálna 5-dutinová projekcia),
A3C, APLAX (Apikálna 3-dutinová projekcia, Apikálna dlhá os)
Skorá diastola (EKG: Koniec T vlny).
CW doppler

Kurzor sa umiestni do LVOT tak aby zachytil:
Outflow prúd v LVOT a inflow prúd mirálnej chlopne.

QRS-Septal e´

Time difference from onset of QRS and septal e´

Čas od QRS (hrotu R) po začiatok septálnej e´ vlny.
Slúži na výpočet T _E-e´
A4C (Apikálna 4-dutinová projekcia).
Systola - Skorá diastola (EKG: R kmit - Koniec T vlny)
Pulsed tissue Doppler.

Kurzor sa umiestni na septálny mitrálny annulus.

QRS-E wave

Time difference from onset of QRS and E wave

Čas od QRS (hrotu R) po začiatok E vlny.
Slúži na výpočet T _E-e´
A4C (Apikálna 4-dutinová projekcia).
Systola - Skorá diastola (EKG: R kmit - Koniec T vlny)
PW doppler.

Kurzor sa umiestni medzi cípy mitrálnej chlopne.
Color doppler (pomôže pri identifikácii prúdu).

T_E-e´

Time difference from onset of E wave and e´

T_E-e´ = QRS-Septal e´ - QRS-E wave
Čas od začiatku E vlny po začiatok septálnej e´ vlny.
Pomocný parameter pri diagnostike diastolickej dysfunkcie.

IVRT/T_E-e´

Isovolumic Relaxation Time and Time difference from onset of E wave and e´ ratio

IVRT/T_E-e´ = IVRT / T_E-e´
Pomer izovolumickej relaxačnej fázy a času medzi E a septálnou e´ vlnou.
Pomocný parameter pri diagnostike diastolickej dysfunkcie a mitrálnej valvulopatie.

Zdroje:

Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)

Recommendations for the Evaluation of LV Diastolic Function by Echocardiography: An Update from the ASE and EACVI (2016)

Recommendations on the use of echocardiography in adult hypertension: a report from the EACVI and the ASE (2015)

Recommendations on the Echocardiographic Assessment of Aortic Valve Stenosis: A Focused Update from the EACVI and the ASE (2017)

ASE Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation (2017)

Guidelines for performing a comprehensive TTE examination in adults: Recommendations from the ASE (2018)

Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: ASE, EACVI, ESC, CSE (2010)

Guidelines for the diagnosis and management of acute pulmonary embolism ESC, ERS (2019)

Echocardiography in aortic diseases: EAE recommendations for clinical practice (2010)

Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice (2009)

ESSENTIAL ECHOCARDIOGRAPHY A Companion to Braunwald’s Heart Disease

Coronary Artery Territories (Echocardiography Illustrated Book 4)

Základné parametre

E-wave

cm/s

Peak velocity in early diastole (Passive flow)

A-wave

cm/s

Peak velocity in late diastole (Atrial contraction)

MV E/A

MV E/A = E-wave / A-wave

Lateral e´

cm/s

Lateral mitral annulus velocity (Early diastole)

Septal e´

cm/s

Septal mitral annulus velocity (Early diastole)

Average e´

cm/s

Average e´ = (Lateral e´+ Septal e´) / 2

MV E/e´

MV E/e´ = E-wave / Average e´

Vmax TR

m/s

Peak tricuspidal regurgitation velocity

LA volume

ml/m²

Left atrial volume (Biplane)

Rozšírené parametre

Lateral E/e´

Lateral E/e´ = E-wave / Lateral e´

MV DT

Mitral valve deceleration time

PV S wave

cm/s

Pulmonary vein peak velocity (Early systole)

PV D wave

cm/s

Pulmonary vein peak velocity (Early diastole)

PV S/D ratio

PV S/D ratio = PV S wave / PV D wave

PV S VTI

Pulmonary vein S wave velocity time integral

Total PV VTI

Total pulmonary vein inflow velocity time integral

PV_sys.fraction

Pulmonary vein systolic filling fraction
PV_sys.fraction = PV S VTI / Total PV VTI x 100

PV AR_duration

Pulmonary vein atrial reversal flow duration

MV A_duration

Mitral valve A-wave duration

AR-A

Time difference (PV AR_duration, MV A_duration)
AR-A = PV AR_duration - MV A_duration

L wave

Transmitral flow during diastasis

Vp_colorM

cm/s

Transmitral flow propagation velocity (Color M-mode)

E/Vp_colorM

E wave and transmitral flow propagation velocity ratio
E/Vp_colorM = E-wave / Vp_colorM

AccR_{E wave}

cm/s²

Peak acceleration rate of mitral inflow E wave

PV DT_{D wave}

Deceleration time of pulmonary venous diastolic velocity

IVRT

Isovolumic Relaxation Time

QRS-Septal e´

Time difference from onset of QRS and septal e´

QRS-E wave

Time difference from onset of QRS and E wave

T_E-e´

Time difference from onset of E wave and e´ wave
T_E-e´ = QRS-Septal e´ - QRS-E wave

IVRT/T_E-e´

Isovolumic Relaxation Time and Time
difference from onset of E wave and e´ ratio
IVRT/T_E-e´ = IVRT / T_E-e´

E-wave

Peak velocity in early diastole (Passive flow)

Maximálna rýchlosť prúdu počas skorej diastoly ľavej komory.
Slúži na výpočet MV E/A, MV E/e´, Lateral E/e´, E/Vp_colorM
A4C (Apikálna 4-dutinová projekcia).
Skorá diastola (EKG: Koniec T vlny).
PW doppler.

Kurzor sa umiestni medzi cípy mitrálnej chlopne.
Color doppler (pomôže pri identifikácii prúdu).

Recommendations for the Evaluation of LV Diastolic Function by Echocardiography: An Update from the ASE and EACVI (2016)

Guidelines for performing a comprehensive TTE examination in adults: Recommendations from the ASE (2018)

Echocardiography: Diastolic dysfunction grading (Algorithm)

LAP indeterminate if only 1 of 3 parameters available. Pulmonary vein S/D ratio <1 applicable to conclude elevated LAP in patients
with depressed LV EF.

Recommendations for the Evaluation of LV Diastolic Function by Echocardiography: An Update from the ASE and EACVI (2016)

Assessment of LV filling pressures in special populations
Disease	Echocardiographic measurements and cutoff values
Atrial fibrillation	Peak acceleration rate of mitral E velocity (≥1,900 cm/sec ²) IVRT (≤65 msec) DT of pulmonary venous diastolic velocity (≤220 msec) E/Vp ratio (≥1.4) Septal E/e´ ratio (≥11)
Sinus tachycardia	Mitral inflow pattern with predominant early LV filling in patients with EFs <50% IVRT ≤70 msec is specific (79%) Pulmonary vein systolic filling fraction ≤40% is specific (88%) Average E/e´ >14 (this cutoff has highest specificity but low sensitivity) When E and A velocities are partially or completely fused, the presence of a compensatory period after premature beats often leads to separation of E and A velocities which can be used for assessment of diastolic function
Hypertrophic cardiomyopathy	Average E/e´ (>14) Ar-A (≥30 msec) TR peak velocity (>2.8 m/sec) LA volume (>34 mL/m2).
Restrictive cardiomyopathy	DT (<140 msec) Mitral E/A (>2.5) IVRT (<50 msec has high specificity) Average E/e´ (>14)
Noncardiac pulmonary hypertension	Lateral E/e´ can be applied to determine whether a cardiac etiology is the underlying reason for the increased pulmonary artery pressures When cardiac etiology is present, lateral E/e´ is >13, whereas in patients with pulmonary hypertension due to a noncardiac etiology, lateral E/e´ is <8
Mitral stenosis	IVRT (<60 msec has high specificity) IVRT/T_E-e´ (<4.2) Mitral A velocity (>1.5 m/sec)
Mitral regurgitation	Ar-A (≥30 msec) IVRT (<60 msec has high specificity) IVRT/T_E-e´ (<5.6) may be applied for the prediction of LV filling pressures in patients with MR and normal EFs Average E/e´ (>14) may be considered only in patients with depressed EFs

Assessment of LV filling pressures in special populations
Disease	Echocardiographic measurements and cutoff values
Atrial fibrillation	Peak acceleration rate of mitral E velocity (≥1,900 cm/sec ²) IVRT (≤65 msec) DT of pulmonary venous diastolic velocity (≤220 msec) E/Vp ratio (≥1.4) Septal E/e´ ratio (≥11)
Sinus tachycardia	Mitral inflow pattern with predominant early LV filling in patients with EFs <50% IVRT ≤70 msec is specific (79%) Pulmonary vein systolic filling fraction ≤40% is specific (88%) Average E/e´ >14 (this cutoff has highest specificity but low sensitivity) When E and A velocities are partially or completely fused, the presence of a compensatory period after premature beats often leads to separation of E and A velocities which can be used for assessment of diastolic function
Hypertrophic cardiomyopathy	Average E/e´ (>14) Ar-A (≥30 msec) TR peak velocity (>2.8 m/sec) LA volume (>34 mL/m2).
Restrictive cardiomyopathy	DT (<140 msec) Mitral E/A (>2.5) IVRT (<50 msec has high specificity) Average E/e´ (>14)
Noncardiac pulmonary hypertension	Lateral E/e´ can be applied to determine whether a cardiac etiology is the underlying reason for the increased pulmonary artery pressures When cardiac etiology is present, lateral E/e´ is >13, whereas in patients with pulmonary hypertension due to a noncardiac etiology, lateral E/e´ is <8
Mitral stenosis	IVRT (<60 msec has high specificity) IVRT/T_E-e´ (<4.2) Mitral A velocity (>1.5 m/sec)
Mitral regurgitation	Ar-A (≥30 msec) IVRT (<60 msec has high specificity) IVRT/T_E-e´ (<5.6) may be applied for the prediction of LV filling pressures in patients with MR and normal EFs Average E/e´ (>14) may be considered only in patients with depressed EFs

Assessment of LV filling pressures in special populations
Disease	Echocardiographic measurements and cutoff values
Atrial fibrillation	Peak acceleration rate of mitral E velocity (≥1,900 cm/sec ²) IVRT (≤65 msec) DT of pulmonary venous diastolic velocity (≤220 msec) E/Vp ratio (≥1.4) Septal E/e´ ratio (≥11)
Sinus tachycardia	Mitral inflow pattern with predominant early LV filling in patients with EFs <50% IVRT ≤70 msec is specific (79%) Pulmonary vein systolic filling fraction ≤40% is specific (88%) Average E/e´ >14 (this cutoff has highest specificity but low sensitivity) When E and A velocities are partially or completely fused, the presence of a compensatory period after premature beats often leads to separation of E and A velocities which can be used for assessment of diastolic function
Hypertrophic cardiomyopathy	Average E/e´ (>14) Ar-A (≥30 msec) TR peak velocity (>2.8 m/sec) LA volume (>34 mL/m2).
Restrictive cardiomyopathy	DT (<140 msec) Mitral E/A (>2.5) IVRT (<50 msec has high specificity) Average E/e´ (>14)
Noncardiac pulmonary hypertension	Lateral E/e´ can be applied to determine whether a cardiac etiology is the underlying reason for the increased pulmonary artery pressures When cardiac etiology is present, lateral E/e´ is >13, whereas in patients with pulmonary hypertension due to a noncardiac etiology, lateral E/e´ is <8
Mitral stenosis	IVRT (<60 msec has high specificity) IVRT/T_E-e´ (<4.2) Mitral A velocity (>1.5 m/sec)
Mitral regurgitation	Ar-A (≥30 msec) IVRT (<60 msec has high specificity) IVRT/T_E-e´ (<5.6) may be applied for the prediction of LV filling pressures in patients with MR and normal EFs Average E/e´ (>14) may be considered only in patients with depressed EFs

Assessment of LV filling pressures in special populations
Disease	Echocardiographic measurements and cutoff values
Atrial fibrillation	Peak acceleration rate of mitral E velocity (≥1,900 cm/sec ²) IVRT (≤65 msec) DT of pulmonary venous diastolic velocity (≤220 msec) E/Vp ratio (≥1.4) Septal E/e´ ratio (≥11)
Sinus tachycardia	Mitral inflow pattern with predominant early LV filling in patients with EFs <50% IVRT ≤70 msec is specific (79%) Pulmonary vein systolic filling fraction ≤40% is specific (88%) Average E/e´ >14 (this cutoff has highest specificity but low sensitivity) When E and A velocities are partially or completely fused, the presence of a compensatory period after premature beats often leads to separation of E and A velocities which can be used for assessment of diastolic function
Hypertrophic cardiomyopathy	Average E/e´ (>14) Ar-A (≥30 msec) TR peak velocity (>2.8 m/sec) LA volume (>34 mL/m2).
Restrictive cardiomyopathy	DT (<140 msec) Mitral E/A (>2.5) IVRT (<50 msec has high specificity) Average E/e´ (>14)
Noncardiac pulmonary hypertension	Lateral E/e´ can be applied to determine whether a cardiac etiology is the underlying reason for the increased pulmonary artery pressures When cardiac etiology is present, lateral E/e´ is >13, whereas in patients with pulmonary hypertension due to a noncardiac etiology, lateral E/e´ is <8
Mitral stenosis	IVRT (<60 msec has high specificity) IVRT/T_E-e´ (<4.2) Mitral A velocity (>1.5 m/sec)
Mitral regurgitation	Ar-A (≥30 msec) IVRT (<60 msec has high specificity) IVRT/T_E-e´ (<5.6) may be applied for the prediction of LV filling pressures in patients with MR and normal EFs Average E/e´ (>14) may be considered only in patients with depressed EFs

Assessment of LV filling pressures in special populations
Disease	Echocardiographic measurements and cutoff values
Atrial fibrillation	Peak acceleration rate of mitral E velocity (≥1,900 cm/sec ²) IVRT (≤65 msec) DT of pulmonary venous diastolic velocity (≤220 msec) E/Vp ratio (≥1.4) Septal E/e´ ratio (≥11)
Sinus tachycardia	Mitral inflow pattern with predominant early LV filling in patients with EFs <50% IVRT ≤70 msec is specific (79%) Pulmonary vein systolic filling fraction ≤40% is specific (88%) Average E/e´ >14 (this cutoff has highest specificity but low sensitivity) When E and A velocities are partially or completely fused, the presence of a compensatory period after premature beats often leads to separation of E and A velocities which can be used for assessment of diastolic function
Hypertrophic cardiomyopathy	Average E/e´ (>14) Ar-A (≥30 msec) TR peak velocity (>2.8 m/sec) LA volume (>34 mL/m2).
Restrictive cardiomyopathy	DT (<140 msec) Mitral E/A (>2.5) IVRT (<50 msec has high specificity) Average E/e´ (>14)
Noncardiac pulmonary hypertension	Lateral E/e´ can be applied to determine whether a cardiac etiology is the underlying reason for the increased pulmonary artery pressures When cardiac etiology is present, lateral E/e´ is >13, whereas in patients with pulmonary hypertension due to a noncardiac etiology, lateral E/e´ is <8
Mitral stenosis	IVRT (<60 msec has high specificity) IVRT/T_E-e´ (<4.2) Mitral A velocity (>1.5 m/sec)
Mitral regurgitation	Ar-A (≥30 msec) IVRT (<60 msec has high specificity) IVRT/T_E-e´ (<5.6) may be applied for the prediction of LV filling pressures in patients with MR and normal EFs Average E/e´ (>14) may be considered only in patients with depressed EFs

Echokardiografia

Diastolická funkcia ľavej komory

E-wave

A-wave

MV E/A

Valsalvov manéver

Lateral e´

Septal e´

Average e´

MV E/e´

Vmax TR

LA volume

Lateral E/e´

MV DT

PV S wave

PV D wave

PV S/D ratio

PV S VTI

Total PV VTI

PVsys.fraction

PV ARduration

MV Aduration

AR-A

L wave

VpcolorM

E/VpcolorM

AccRE wave

PV DTD wave

IVRT

QRS-Septal e´

QRS-E wave

TE-e´

IVRT/TE-e´

E-wave

A-wave

MV E/A = E-wave / A-wave

Valsalvov manéver

Lateral e´

Septal e´

Average e´= (Lateral e´+ Septal e´) / 2

MV E/e´= E-wave / Average e´

Vmax TR

LA volume

Lateral E/e´= E-wave / Lateral e´

MV DT

PV S/D ratio = PV S wave / PV D wave

PV S wave

PV D wave

PVsys.fraction = PV S VTI / Total PV VTI x 100

PV S VTI

Total PV VTI

AR-A = PV ARduration - MV Aduration

PV ARduration

MV Aduration

L wave

VpcolorM

E/VpcolorM = E-wave / VpcolorM

AccRE wave

PV DTD wave

IVRT

TE-e´ = QRS-Septal e´ - QRS-E wave

QRS-Septal e´

QRS-E wave

IVRT/TE-e´ = IVRT / TE-e´

PV_sys.fraction

PV AR_duration

MV A_duration

Vp_colorM

E/Vp_colorM

AccR_{E wave}

PV DT_{D wave}

T_E-e´

IVRT/T_E-e´

PV_sys.fraction = PV S VTI / Total PV VTI x 100

AR-A = PV AR_duration - MV A_duration

PV AR_duration

MV A_duration

Vp_colorM

E/Vp_colorM = E-wave / Vp_colorM

AccR_{E wave}

PV DT_{D wave}

T_E-e´ = QRS-Septal e´ - QRS-E wave

IVRT/T_E-e´ = IVRT / T_E-e´