This review highlights the physiological basis and heterogeneity of left ventricular diastolic filling patterns in congestive cardiomyopathy as assessed by Doppler echocardiography.
Advises cautious Doppler interpretation in cardiomyopathy; leaves open prospective validation of pattern-guided management.
The left ventricular diastolic filling pattern in congestive cardiomyopathy is heterogeneous and may vary from a “rapid filling predominant pattern” to an “atrial filling predominant pattern.” The observed pattern of diastolic filling may depend on a complex interaction of factors including: left ventricular relaxation, left ventricular stiffness, external constraining forces, loading conditions, and heart rate. These factors appear to express themselves individually and collectively through alterations in the time course and extent of the transmitral pressure gradient. In this review, the physiological basis for each of these diastolic filling patterns is discussed based on previous clinical and experimental studies that either directly or indirectly address these issues. (ECHOCARDIOGRAPHY, Volume 8, March 1991)
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STEVEN J. LA VINE (1991) studied this question.
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