Mastering Diastology: Part 4

Mastering Diastology: Part 4

HYPERTROPHIC CARDIOMYOPATHY

There are elevated filling pressures if any of the following are true:

  • Average E/e’ > 14
  • Pulmonary venous AR duration minus mitral A-duration > 30 msec
  • TR Peak Velocity > 2.8 m/s
  • LA  Volume Index > 34 mL/m²

If average E/e’ is unobtainable or not used routinely in your lab, use “septal E/e’ >15” or “lateral E/e’ >13” to determine elevated filling pressures.

RESTRICTIVE CARDIOMYOPATHY

There are elevated filling pressures if any of the following are true:

  • Mitral inflow deceleration time < 140 msec
  • Mitral E/A ratio > 2.5
  • IVRT < 50 msec
  • Average E/e’ >14

If mitral e’ > 8 cm/s then consider constrictive pericarditis. Also consider constrictive pericarditis  if lateral e’ is less than septal e’.

ADDITIONAL NOTES:

Hepatic vein end-diastolic reversal velocity (measured on expiration) divided by forward flow velocity is definite constrictive pericarditis if > 0.8. Restrictive cardiomyopathy will have septal e’ < 6 cm/s.

If average E/e’ is unobtainable or not used routinely in your lab, use “septal E/e’ >15” or “lateral E/e’ >13” to determine elevated filling pressures.

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