Doppler Mitral Inflow velocity profile is the key to assess LV diastolic function . The ratio between E and A has become most popular parameter .
In the absence of atrial contraction what shall we do ?
The answer is simple . We have 2 D parameters of LV diastolic function.
LA dimension ( > 30 % basal dimension which is usually > 4 cm ) is a most specific marker of diastolic dysfunction in the absence of mitral regurgitation or stenosis.
The only available velocity E wave profile can help .A short E deceleration time in a short cycle would suggest significant diastolic dysfunction.High amplitude E wave > 2 M/sec in the absence of MR will suggest diastolic dysfunction .
Curiously , it can be assumed an episode of lone AF per-se , be an indicator of diastolic stress for the left atrium .
After all , why should a person all of a sudden develop an episode of AF .(Hypoxia, Ischemia , excluded )
Mitral annular velocities / E propagation velocity / E/E’ are other tissue Doppler parameters can be used.
Pulmonary venous flow velocity is largely not useful (Since A reversal does not occur )