Table 30—

Factors favouring diagnosis of left ventricular diastolic dysfunction in the presence of pulmonary hypertension as assessed by Doppler echocardiography

Clinical features
 Age >65 yrs
 Elevated systolic blood pressure
 Elevated pulse pressure
 Obesity, metabolic syndrome
 Hypertension
 Coronary artery disease
 Diabetes mellitus
 Atrial fibrillation
Echocardiography
 Left atrial enlargement
 Concentric remodelling of the LV (relative wall thickness >0.45)
 LV hypertrophy
 Presence of echocardiographic indicators of elevated LV filling pressure 64, 226
Interim evaluation (after echocardiography)
 Symptomatic response to diuretics
 Exaggerated increase in systolic blood pressure with exercise
 Re-evaluation of chest radiograph consistent with heart failure 226
  • LV: left ventricle. Modified from Hoeper et al.227, with permission from the publisher.