The assessment of left ventricular filling pressure (LVFP), such as the left ventricular end-diastolic pressure (LVEDP) and the mean left atrial pressure (LAP), provides important information about the diastolic function of the left ventricle (LV).

Diastolic function essentially determines the ability of the LV to fill to an adequate volume at end-diastole to ensure that there is an adequate stroke volume during systole. When there is normal diastolic function, the LV is able to fill to an adequate end-diastolic volume, at low LV filling pressures, during rest or exercise, ensuring an adequate stroke volume during systole. Diastolic dysfunction means that in order for the LV to fill to an adequate end-diastolic volume, during rest or exercise, there is an abnormal increase in LV filling pressures. While it is not possible to precisely measure the LVFP from conventional diastolic Doppler parameters, the diastolic filling patterns displayed by the spectral Doppler examination reflect a general relationship to these filling pressures. For example, a normal diastolic filling profile suggests normal LVFP; a delayed relaxation profile is usually associated with normal LAP; a pseudonormal filling profile usually reflects a moderate increase in LAP while a restrictive filling profile usually indicates a marked increase in the LAP.

This presentation will discuss (1) the spectral Doppler measurements that should be routinely performed for the estimation of LVFP, (2) technical aspects to ensure measurement accuracy and (3) the relationship of spectral Doppler parameters to LVFP.