State-of-the-Art Paper
Unlocking the Mysteries of Diastolic Function: Deciphering the Rosetta Stone 10 Years Later

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It has now been a quarter of a century since the first description by Kitabatake and his associates of the use of echo-Doppler to characterize the transmitral flow velocity curves in various disease states. A decade ago we described the role of echocardiography in the “Evaluation of Diastolic Filling of Left Ventricle in Health and Disease: Doppler Echocardiography Is the Clinician’s Rosetta Stone.” Over the ensuing decade, advances in echo-Doppler have helped to further decipher the morphologic and physiological expression of cardiovascular disease and unlock additional mysteries of diastology. The purpose of this review is to highlight the developments in echo-Doppler and refinements in our knowledge that have occurred over the past decade that enhance our understanding of diastology.

Abbreviations and Acronyms

A
A velocity
ACEI
angiotensin-converting enzyme inhibitor
ARA
aldosterone receptor antagonist
ARB
angiotensin I receptor antagonist
DT
deceleration time
DTI
Doppler tissue imaging
E
E velocity
Ea
arterial elastance
IVRT
isovolumic relaxation time
LA
left atrium
LV
left ventricle/ventricular
LVOT
left ventricular outflow tract
SRivr
strain rate during the isovolumic relaxation phase of the cardiac cycle
Vp
mitral inflow propagation velocity

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