Which Doppler measurements are used to assess diastolic function?

• A. Systolic ejection fraction.
• B. QRS duration.
• C. E/A and E/e' ratios.
• D. Pulmonary capillary wedge pressure.

Answer: (C)

Doppler assessment of diastolic function looks at how blood fills the left ventricle during diastole and how the myocardium relaxes. The mitral inflow pattern provides the E wave, which is the rapid early filling velocity, and the A wave, which comes from atrial contraction. The E/A ratio compares these two phases and reveals whether early filling is reduced or whether filling relies more on atrial contraction—a sign of different stages of diastolic dysfunction. To refine this, tissue Doppler measures e’, the myocardial relaxation velocity at the mitral annulus. The E/e’ ratio combines these signals to estimate left ventricular filling pressures noninvasively: a higher ratio suggests higher filling pressures and worse diastolic function.

Other options aren’t Doppler-based assessments of diastolic function. Systolic ejection fraction assesses systolic performance, not diastolic filling. QRS duration is an ECG interval reflecting ventricular depolarization, not diastolic filling. Pulmonary capillary wedge pressure is an invasive hemodynamic pressure measurement, not a Doppler-derived diastolic index.