Left Ventricular Diastolic Function in Atrial Fibrillation: Methodological Implications and Clinical Considerations

The assessment of LVDD is routinely included in echocardiographic evaluation because it correlates with cardiac disease progression and its prognostic value. Classic parameters used for assessing LV diastolic function correlate well with invasive measurements which remains the gold standard. Nevertheless, no one echocardiographic parameter alone can completely evaluate LVDD. LV diastolic function evaluation in atrial fibrillation is still challenging, since the E/A ratio, one of the most used parameters in echocardiographic evaluation, cannot be feasible. This is not a good reason to give up measurement. In this review, we analyze the different methods for estimating LV diastolic function in atrial fibrillation, including measurement not dependent on atrial systole and some novel methods that are promising, but not ever available during clinical practice highlighting that this assessment is mandatory for a complete clinical evaluation of the patients. Left ventricular diastolic dysfunction (LVDD) is involved in the pathogenesis of many cardiac diseases. It is diagnosed by a Doppler-echocardiogram. LVDD diagnosis in atrial fibrillation is neglected because of the absence of an A wave. In this review, we analyze many different methods for diagnosis of LVDD in atrial fibrillation. image