Adult Echocardiography Practice Exam

How would you classify abnormal diastolic function characterized by an E:A ratio of .78:1?

1. Grade I

2. Grade III

3. Grade II

4. Grade IV

The correct answer is: Grade I

The classification of diastolic dysfunction is based on the assessment of the E:A ratio, which represents the ratio of early (E) to late (A) diastolic filling velocities of the left ventricle obtained via Doppler echocardiography. An E:A ratio of 0.78:1 indicates a reduced early filling velocity relative to late filling, which suggests impaired relaxation of the left ventricle. In this context, Grade I diastolic dysfunction, also known as "mild" diastolic dysfunction, is characterized by the presence of an E:A ratio less than 1 but greater than 0.75, along with other factors such as a normal E wave deceleration time and isovolumetric relaxation time. The E:A ratio of 0.78 fits this classification, indicating that while there is some impairment in diastolic filling, it is not yet severe. In contrast, Grade II diastolic dysfunction would typically show an E:A ratio that is equal to or greater than 1, whereas Grade III and IV would indicate more advanced stages of diastolic dysfunction with increasingly abnormal patterns and findings. Thus, the identification of an E:A ratio of 0.78:1 aligns distinctly