title: Studying diastology with speckle tracking echocardiography: The essentials.
abstract: Diastolic dysfunction is common in cardiac disease and an important finding independent of systolic function as it contributes to the signs and symptoms of heart failure. Tissue Doppler mitral early diastolic velocity (Ea) combined with peak transmitral early diastolic velocity (E) to obtain E/Ea ratio provides an estimate of the left ventricular (LV) filling pressure. However, E/Ea has a significant gray zone and less reliable in patients with preserved ejection fraction (>50%). Two-dimensional echocardiographic speckle tracking measure myocardial strain and strain rate (Sr) avoiding the Doppler-associated angulation errors and tethering artifacts. Global myocardial peak diastolic strain (Ds) and diastolic Sr (DSr) at the time of E and isovolumic relaxation combined with E (E/Ds and E/10 DSr) have been recently proposed as novel indices to determine LV filling pressure. The present article elucidates the methodology of studying diastology with strain echocardiography along with the advantages and limitations of the novel technique in light of the available literature.
authors.affiliation: Department of Cardiac Anaesthesia, CTC, AIIMS, New Delhi, India.
authors.forename: Arindam
authors.initials: A
authors.lastname: Choudhury
authors.affiliation: Department of Cardiac Anaesthesia, CTC, AIIMS, New Delhi, India.
authors.forename: Rohan
authors.initials: R
authors.lastname: Magoon
authors.affiliation: Department of Cardiac Anaesthesia, CTC, AIIMS, New Delhi, India.
authors.forename: Vishwas
authors.initials: V
authors.lastname: Malik
authors.affiliation: Department of Cardiac Anaesthesia, CTC, AIIMS, New Delhi, India.
authors.forename: Poonam Malhotra
authors.initials: PM
authors.lastname: Kapoor
authors.affiliation: Department of Cardiology, CTC, AIIMS, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Ramakrishnan
mesh_terms: D002309:Cardiology / Q000379:methods*; D003971:Diastole; D004452:Echocardiography / Q000379:methods*; D006321:Heart / Q000503:physiopathology; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D009206:Myocardium / Q000473:pathology