2D echocardiography not It allows you to directly Rate Vat diastolic function of the left ventricle , however, may reveal associated with It LVH , violations of local by kratimosti , infiltrative diseases myocardium or thickening of the leaves of the pericardium . Alongside with diastolic dysfunction can be detected violation sistoliche tion function of the left ventricle . Special features Diastolic the blood flow ka of LP at LV can be studied with using pulse doppler – echocardiography . For of this control volume is set on level of the cusps of the mitral valve at apical four- position . This study allows to obtain a spectrum of good quality transmitral blood flow .
AT Normally transmitral bloodstream has the following characteristics ( Fig . 6.6, A).
. Peak E passive early diastolic Napoli nenie LV .
. Peak BUT – active later diastolic Napoli nenie LV .
. Ratio E / A— > 1.
With LV relaxation disorder at connections gipertro fiey or myocardial ischemia an increase in peak BUT and reduction peak E . With In this respect, the E / A ratio becomes less than 1 ( Fig . 6.6, B). Time deceleration of peak E is lengthened (> 220 ms ).
Have patients older than 50 years for confirmation dia stolicheskoy dysfunction required reduction ratio E / A of less than 0.5 in connections with normal increase am plitudy peakBUT with of this age . This type diastema netocrystalline dysfunction received the title of ” slow relaxation ” and reflects reduced LV compliance . With This is marked by an increase in the pre- rhythm systole contribution . at filling the ventricle .
With tackle extensibility infarction due infiltrative disorders or constrictive pericarditis peak E becomes very high , and the peak BUT low . Time deceleration peak E ukorachi INDICATES (<150 ms ). These violations diastole include to restrictive type and reflect an increase in diastolic pressure of course at LV . Filling of the ventricle occurs quickly. atearly diastole , when this contraction schenie atrial unable longer stretch of LV .