T Jake Samuel1, Rhys Beaudry1, Satyam Sarma2,3, Vlad Zaha2, Mark J Haykowsky1, Michael D Nelson4. 1. The University of Texas at Arlington, Engineering Research Building 453, 500 UTA Blvd, Arlington, TX, 76019, USA. 2. The University of Texas Southwestern Medical Center, Dallas, TX, USA. 3. Institute of Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA. 4. The University of Texas at Arlington, Engineering Research Building 453, 500 UTA Blvd, Arlington, TX, 76019, USA. Michael.Nelson3@uta.edu.
Abstract
PURPOSE OF REVIEW: This review summarizes recent developments highlighting the clinical utility of diastolic stress testing along the heart failure continuum. RECENT FINDINGS: Invasive hemodynamic assessment of cardiac filling pressures during physiological stress is the gold-standard technique for unmasking diastolic dysfunction. Non-invasive surrogate techniques, such as Doppler ultrasound, have shown excellent agreement with invasive approaches and are now recommended by the American Society of Echocardiography and the European Association of Cardiovascular Imaging. While cycle exercise is often advocated, recent evidence supports the use of isometric handgrip as a viable alternative stressor. Diastolic stress testing is a powerful tool to enhance detection of diastolic dysfunction, is able to differentiate between cardiac and non-cardiac pathology, and should be incorporated into routine clinical assessment.
PURPOSE OF REVIEW: This review summarizes recent developments highlighting the clinical utility of diastolic stress testing along the heart failure continuum. RECENT FINDINGS: Invasive hemodynamic assessment of cardiac filling pressures during physiological stress is the gold-standard technique for unmasking diastolic dysfunction. Non-invasive surrogate techniques, such as Doppler ultrasound, have shown excellent agreement with invasive approaches and are now recommended by the American Society of Echocardiography and the European Association of Cardiovascular Imaging. While cycle exercise is often advocated, recent evidence supports the use of isometric handgrip as a viable alternative stressor. Diastolic stress testing is a powerful tool to enhance detection of diastolic dysfunction, is able to differentiate between cardiac and non-cardiac pathology, and should be incorporated into routine clinical assessment.
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