Conclusion
The assessment of LV diastolic dysfunction in patients with MS is
challenging. Identification of concomitant diastolic disorders is
imperative in the management of older subjects with co-existent systemic
disease, co-morbidities and mismatch between symptom class and MVOA, and
to identify subgroups that may not benefit from balloon intervention.
Such subjects may benefit from optimal medical therapy to decrease blood
pressure, lower heart rate, improve LV diastolic filling and with
diuretics to lower PH. Conventional echocardiographic methods are of
limited value to assess LV diastolic dysfunction in MS. IVRT/TE-e´ ratio is the recommended method to identify the
presence of raised LV filling pressure. Newer diagnostic methods like
speckle tracking echocardiography show promise, but widespread utility
is currently limited owing to insufficient data.