Key result
Speckle tracking echocardiography shows potential to better estimate LV filling pressure in diastolic dysfunction.
Why the study?
Despite existing guidelines, a definitive consensus on echocardiographic parameters that reliably correlate with a wide range of intraoperative left ventricular filling pressures is lacking, prompting evaluation of advanced quantitative modalities.
Comparison
Upcoming echocardiographic modalities vs existing techniques for estimating LVFP
Design
Review
This review summarizes existing and emerging echocardiographic techniques, such as speckle tracking, for estimating left ventricular filling pressures and assessing diastolic dysfunction.
Assessment of diastolic dysfunction is a cardiac anesthesiologist’ holy grail, considering the increasing recognition of diastolic dysfunction (DD) in cardiac surgical patient and its’ impact on the associated outcomes. Withstanding, there is a growing recent emphasis on the accurate, reliable, and reproducible echocardiographic measurement of left ventricular filling pressure (LVFP) for the quantification of DD; which essentially denotes an intrinsic relaxation abnormality. Despite a comprehensive 2016 American Society of Echocardiography and the European Association of Cardiovascular Imaging (ASE/EACVI) guideline for echocardiographic evaluation of the diastolic function, a definitive consensus on the echocardiographic parameters that correlate well with a wide range of intraoperative LVFP is lacking. The recent guidelines continue to focus mainly on the qualitative parameters. However, prompted by the limitation of the existing technique in predicting the quantitative diastolic function across diverse clinical scenario, a range of upcoming echocardiographic modalities are being evaluated with regards to their potential as surrogates of filling pressure in comparison to existing technique. These advanced echocardiographic techniques include speckle tracking echocardiography and pulmonary vein diastolic wave deceleration time, with the evolving role of former being categorically stated in the recent 2025 ASE documents outlining context-specific recommendations on LVDD. The index article, hence aims to review the existing and upcoming echocardiographic modalities as diastolic function assessment correlates particularly with regards to the technique, advantages, limitations, clinical application, and the relevant associated literature.
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Das et al. (2026) studied this question. Upcoming echocardiographic modalities like speckle tracking are being evaluated for their potential to better estimate left ventricular filling pressure in diastolic dysfunction assessment.
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