Table 5 Diagnostic tools in the assessment of systolic and diastolic dysfunction
Systolic function
  • Echocardiography/MRI:

  • Volumes

  • Fractional shortening

  • Velocity of fractional shortening

  • Ejection fraction (planimetry)

  • Response to stress (dobutamine)

  • Wall motion

  • Exercise ECG:

  • Exercise capacity

  • Oxygen consumption*

  • Pressure×heart rate product

  • Radionuclide angiography (MUGA):

  • Ejection fraction

  • Cardiac volumes

  • Pattern of contractility

  • Myocardial perfusion imaging with gating:

  • Regional myocardial perfusion

  • Cardiac volumes

  • Ejection fraction

  • Wall motion and wall thickening

Diastolic function
  • Echocardiography/MRI/MUGA:

  • E/A ratio

  • Deceleration time

  • A and E waves

  • Relaxation times

  • Most of the techniques mentioned have been validated in normal subjects and patients with cardiac failure.

  • *Oxygen consumption (ml/min)  =  12×effect (W)/body weight (kg) +3.5).

  • E/A ratio, ratio of early to late (atrial) phases of ventricular filling; MUGA, multigated acquisition.