Key Points
- To outline the clinical value and application of Doppler echocardiography in evaluating left ventricular diastolic function and filling pressures across diverse ejection fraction phenotypes.
- Synthesized diagnostic frameworks assessing non-invasive two-dimensional, conventional Doppler, and tissue Doppler echocardiographic variables.
- Evaluated physiological differences and Doppler parameter utility between patients with preserved (LVEF ≥ 50%) and depressed (LVEF < 50%) ejection fractions.
- Tissue Doppler imaging is essential in preserved ejection fraction cases to detect impaired myocardial relaxation that leads to elevated filling pressures and diastolic heart failure.
- Conventional Doppler parameters—including transmitral velocities (E, A, and E/A), deceleration time, pulmonary venous flow, and left atrial volume—adequately evaluate filling pressures in depressed ejection fraction.
- Multiparametric evaluation across multiple Doppler and structural variables prevents diagnostic error compared to relying on any single diastolic parameter.
Structured PICO
PPopulationPatients with dyspnea being evaluated for heart failure (both depressed and preserved LVEF)
IInterventionEchocardiography with Doppler (including tissue Doppler imaging)
OOutcomeAssessment of left ventricular diastolic function and filling pressures
Echocardiography with Doppler provides a comprehensive, non-invasive, and accurate assessment of LV diastolic function, which is essential for diagnosing heart failure in patients with dyspnea.