Brief Answer:
you don't have diastolic dysfunction

Detailed Answer:
Hi Dear,
Thanks for choosing health care magic for your query;

Have noted all your details,

Before commenting anything let me first give you a brief idea about Diastolic dysfunction in 2d echo;

Systole is the phase during which the heart contract and diastole is the phase during which the heart relax.
Under normal conditions most of the blood will fill the ventricle during early diastole (passive filling).Thus, the E-wave is taller than the A-wave. The E/A ratio will be between 1 and 2, normally,yours is 1.8 then 1.67 (perfectly normal)

normal deceleration time(DT) is between 150 ms and 200 ms, yours is 123ms (perfectly normal), 165ms again normal and 163ms again normal.

As per the details mentioned by you its perfectly normal its not even grade 1 diastolic dysfunction.
LVEF 60% is perfectly normal .
I dont think you have any chances of landing up in heart failure in near future.

I would mention here some features of grade 1 diastolic dysfunction just for your satisfaction-

DT will be prolonged (≥ 240 ms)

IVRT will increase (> 100 ms

The A-wave will be larger than normal and will typically also be larger than the E-wave (E/A ratio < 1).
Your heart is perfectly normal,keep on taking the meds you are on!
If you have any more query ,feel free to ask!
If possible post to me the recordings or detailed reports of your 2D ECHO.

Thank you,
Dr Rishu Saxena
Cardiologist

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Brief Answer:
Every thing is in normal range

Detailed Answer:
Hi,

Let me give you a brief idea about diastolic dysfunction first to remove your confusion,
The most important modality to assess diastolic function is the mitral inflow signal,diastolic dysfunction alters the relationship between early and late filling (E- and A-wave), how rapidly flow velocity declines in early diastole (E-wave deceleration time = DT), and how long it takes for filling of the ventricle to start after the ventricle relaxes (length of the isovolumetric relaxation time = IVRT)..

Normal diastolic function-
The E/A ratio will be between 1 and 2.
deceleration time is between 150 ms and 200 ms.
IVRT is 50 - 100 ms.
grade 1 have already described

Pseudonormal filling pattern - grade 2 diastolic dysfunction
d the E/A ratio will return to the range of 0.8 to 1.5.
DT and IVRT (< 90 ms) will also decrease, but your DT is way above it.

Reversible restrictive filling pattern - grade 3 diastolic dysfunction- about which you are concerned
The E/A ratio will be ≥ 2.
short IVRT (≤ 80 ms) and DT (<160 ms)
again your case doesn't fits in it .

So i don't think there is any problem with your heart.
your DT and E/A both are in normal range.
i dont think there is any remotest possiblity of cardiac failure .


Thank you,
Feel free to question!

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Brief Answer:
Details expained!

Detailed Answer:
Hi again,
I can very well understand your query !
see firstly in medical sciences we never treat numbers we treat a patient .
You are physically fit and able to do high intensity exercise ,a patient with restrictive pattern in diastolic failure grade 3 or grade 4 ,will be symptomatic and would atleast present with shortness of breath on walking or climbing upstair.

Restrictive diastolic function means that heart can not fill itself with blood during diastole,if heart does not have adequate blood reserves then is it possible to maintain blood supply to various organs during strenous exercises??
off course no!!

There are a number of literature on internet which will show you that E/A 0.75 to 1.5 is normal and above it is abnormal, infact even deceleration time also differes from book to book !

A doctor follows what's written in a standard book.
The figures which i told you in my previous reply are according to Braunwalds cardiology(bible of cardiac diseases).
Interpretation of echo depends from doctor to doctor ,sensitivity of echo in ruling out a cardiac problem is about 65% ,most of the readings are taken manually and slight variation is there ,even if you repeat this echo at some other hospitals slight variations will be there!

Considering your life style your over all reports your ejection fraction ,i dont think that it can be diastolic dysfunction !

According to braunwalds cardiology your figures fall in normal category !
There are few texts which says that E/A wave ratio greater than 1.5 and deceleration time (DT) less than 160 milliseconds indicates restrictive filling pattern.But again i would like to go with braunwalds datas and your physical condition ,neither of them are indicative that you have a restrictive pattern of filling!

Adviced
Repeat echo

In case you have any other query feel free to ask !
They are all manual tests reading varies from machine to machine ,from technician to technician,overall condition of patient and symptoms are to be considered ,we can't just rely on numbers!

Thank you!
Dr Rishu Saxena
Cardiologist
New XXXXXXX (India)

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