LV Diastolic Stress Test Index Calculator
- LV Diastolic Stress Test Index: Explanation and Clinical Context
The Left Ventricular (LV) Diastolic Stress Test Index, primarily expressed as the ratio of early mitral inflow velocity (E) to early diastolic annular velocity (e′) during peak exercise, is a validated echocardiographic parameter to assess left ventricular filling pressures under stress conditions.
A normal response (E/e′ < 10) suggests adequate relaxation reserve and preserved diastolic function during exercise. An elevated E/e′ ratio (>14) indicates abnormal elevation in LV filling pressure during stress, consistent with diastolic dysfunction and exercise-induced heart failure with preserved ejection fraction (HFpEF). Borderline values (10–14) require integration with other parameters such as TR velocity and pulmonary artery systolic pressure (PASP) to refine interpretation.
This index is especially useful in cases with unexplained exertional dyspnea or suspected HFpEF where resting diastolic parameters are normal. During stress echocardiography, E/e′ measured at peak exercise correlates strongly with invasively measured LV end-diastolic pressure, providing a non-invasive window into diastolic reserve.
Reference:
Nagueh SF, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the ASE and EACVI. J Am Soc Echocardiogr. 2016;29(4):277–314. doi:10.1016/j.echo.2016.01.011
Borlaug BA, et al. Exercise Echocardiography Reveals Diastolic Dysfunction and Predicts Exercise Capacity in HFpEF. Circulation. 2010;122:865–872. doi:10.1161/CIRCULATIONAHA.110.961938
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