ABSTRACT
The diagnosis and management of diastolic heart failure has always been somewhat controversial because it is harder to characterize, and the treatment strategies are less well studied than for systolic heart failure. Many methods are available to characterize left ventricular (LV) diastolic function on echo, but the most widely used are: LV inflow, pulmonary venous flow and tissue Doppler imaging just below the mitral annulus. Isovolumic relaxation time (IVRT) is the time period between aortic valve closure and mitral valve opening, during which LV pressure falls but there is no change in LV volume. There are various methods of measuring IVRT. Patients with LV diastolic dysfunction are treated with diuretics to relieve fluid congestion and any contributing factors should be treated as appropriate. Impairment of LV relaxation increases LV end-diastolic pressure and this consequently impacts on the pulmonary circulation, leading to pulmonary congestion and breathlessness.
