Contemporary notion of evaluation of the diastolic cardiac function and its role in the development of heart failure

Diastolic cardiac function depends on active relaxation of cardiomyocytes a nd passive diastolic properties of ventricles. Deterioration of the latter should consistently be followed by hemodynamic abnormalities such as elevat ed filling pressure or diminished ventricular diastolic dimension. Slowing of relaxation can also be accompanied by similar changes especially in the presence of pronounced tachycardia, but more often it remains compensated a nd does not affect hemodynamics. According to this notion noninvasive inves tigation of cardiac diastolic function should at minimum provide estimates of the state of relaxation and filling pressure level. This would allow to evaluate indirectly passive diastolic properties of a ventricle. Standard d oppler study of mitral blood flow in most cases is not able to give an answ er to these questions. Therefore it is necessary to search novel techniques and their combinations aimed at solution of this problem. At present it se ems most adequate to combine assessment of relaxation by one-dimensional co lor Doppler echocardiography and estimation of filling pressure by blood fl ow through pulmonary veins.