Intraoperative assessment of diastolic function: utility of echocardiography.
OBJECTIVE
This review discusses the current and future applications of different echocardiographic modalities in evaluating diastolic function intraoperatively.


RESULTS
Normal diastolic function is required for optimal cardiac performance. There is sufficient evidence to support the significant prevalence of preoperative diastolic dysfunction and its incidence following cardiac surgery, however controversy still exists regarding the impact of diastolic dysfunction on adverse outcomes. Echocardiography provides a relatively safe, practical and noninvasive means to evaluate perioperative diastolic function, however conventional measures may be limited by the impact of changes in heart rate, rhythm and loading conditions. Newer echocardiographic modalities are reportedly less sensitive to acute changes in loading conditions, and may therefore complement the use of conventional echocardiographic techniques in the perioperative period.


CONCLUSIONS
The availability of effective technology for diagnosing the presence and progression of perioperative diastolic function should assist in the identification of high-risk cardiac surgical patients who may benefit from appropriate triaging and therapeutic intervention.
Djaiani
George N
GN
Department of Anesthesiology and Pain Medicine, Division of Cardiovascular Anesthesia and Intensive Care, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada. george.djaiani@uhn.on.ca
Shernan
Stanton K
SK