Assessment of diastolic function: suggested methods

RECENT STUDIES in diseased hearts have demonstrated that diastolic dysfunction may precede abnormalities in systolic ventricular performance. Therefore, it is important to critically review methods currently being used in the assessment of diastolic function. Many review articles and symposia that express differing points of view have been published recently. '-5 Several of the controversies stem from a misunderstanding of basic principles of physics and mathematics, the use of inappropriate analyses, and the desire to develop simple indexes of diastolic function. The emphasis here will therefore be on the development of relationships between pertinent physiologic parameters, the applications of various mathematic models, and suggestions of topics requiring further study. In particular, attention will be focused on methods for the assessment of chamber stiffness, myocardial stiffness, and the time constant of relaxation since these are important factors involved during shifts in the pressure-volume relationship after drug intervention or pacing-induced angina.