Diastolic dysfunction is  responsible for one third of cases of heart  failure alone and rest two  third of cases in  combination with systolic dysfunction. Diastolic dysfunction can be  assessed by Doppler echocardiography (basics of diastolic dysfunction would be covered in this section)

Doppler Echocardiographic Indices of Diastolic Function:

1)  Mitral inflow velocity (E = wave, A = wave E/A ratio)

2)  Mitral E = wave deceleration time

3)  Isovolumetric relaxation time  (IVRT)

4)  Pulmonary vdin  systolic and diastolic velocity (S,D,S/D ratio)

5) Pulmonary vain  atrial systolic reversal  (PVa)

6)  Difference between PVa  and mitral a wave duration

7)  Tissue Doppl$r at mitral annulus

Transducer positidn: Place the pulsed  sample at  the level of tips of the mitral leaflets in  their fully open diastolic position. The ultrasound beam need  to be parallel with the direction of blood  flow.