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E/e’: > 14 is rare in normal individuals Change in mitral inflow with Valsalva: 50% change in E/A o highly specific for increased LV filling pressures o supports diagnosis of diastolic dysfunction o requires continuous recording of the Doppler signal during 10 seconds of Valsalva Difference in duration between pulmonary vein Ar ve.
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In addition to being a marker of increased risk, diastolic dysfunction may also be a direct contributor to the adverse outcomes, perhaps by contributing to the progression of heart failure by limiting cardiac output reserve, accelerating neuroendocrine activation, increasing symptoms of breathlessness, and promoting physical inactivity .
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