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
 Coronary artery disease
 Diabetes mellitus
 Atrial fibrillation
 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.