Grades of Diastolic Dysfunction

Question 1

Basic description of Mild RV Diastolic Impairment

Answer 1

1. Decreased E
2. Long IVRT
3. Increased Decel. Time
4. Decrease Tissue Doppler
5. S greater than D
6. Ar stays normal (no greater than 137 msec.)

Question 2

Basic description of Moderate RV Diastolic Impairment

Answer 2

1. Increased E Wave (Normalized LV inflow)
2. S decreases
3. Increase in D
4. Increased Ar velocity
5. E’ and A’ in tissue doppler are reversed

Question 3

Basic description of Severe RV Diastolic Impairment

Answer 3

1. Increased E wave (single component)
2. Decreased Decel. time (less than 160 msec)
3. Tissue doppler decreased (less than 10)
4. E / E’ is greater than 15
5. Decrease in S and Increase in D (PV Flow)
6. Ar increases

Question 4

What are the normal ranges for IVRT?

Answer 4

70 - 90 msec

Question 5

What are the ranges for IVRT for the 4 grades of diastolic dysfunction?

Answer 5

I: >90 msec
II: 60 - 90 msec
III: < 70 msec
IV: < 70 msec

Question 6

What are the normal ranges for the E/A ratio?

Answer 6

0.9 - 1.5

Question 7

What rare the ranges for E/A ratio for the 4 grades of diastolic dysfunction?

Answer 7

I: < 0.9
II: 0.9 - 1.5
III: > 1.8
IV: > 2.0

Question 8

What happens to the E/A ratio during valsalva in the 4 grades of diastolic dysfunction?

Answer 8

I: E and A decrease, ratio unchanged
II: E decreases, A increases, ratio reverses
III: Ratio decreases, buts till > 1
IV: No response to valsalva

Question 9

What is the normal range for MV decel time?

Answer 9

140 - 240 msec

Question 10

What are the ranges for MV decel time for the 4 grades of diastolic dysfunction?

Answer 10

I: > 240 msec
II: 140 - 200 msec
III: < 140 msec
IV: < 130 msec

Question 11

What is the normal range for Pulmonary Venous Flow?

Answer 11

S > D

Question 12

What is the normal Ar measurement for PV flow?

Answer 12

< 25 cm.sec

Question 13

What are the values for Ar in the 4 stages of diastolic dysfunction?

Answer 13

I: < 25
II: > 25
III: >25
IV: > 25