Perioperative Assessment of Diastolic Function

Cardiac surgery is commonly performed on patients with some degree of functional impairment of myocardial function. In fact, heart failure is a frequent presenting feature for most patients who require surgical treatment. Despite the evidence surrounding the impact of diastolic dysfunction in cardiovascular disease, perioperative echocardiographic assessment remains poorly understood and its importance underappreciated. There is emerging data to suggest that assessment of diastolic function can both aid hemodynamic management and help prognosticate outcome. The text discusses the challenges and limitations of current techniques and proposes a pragmatic approach to the assessment of diastolic function in the perioperative period.