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. 2022 Jul 26;37(2):379–399. doi: 10.1007/s10557-022-07355-7

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© The Author(s) 2022

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 4 — Echocardiography prior to and post exercise can reveal comparatively subtle increases in diastolic dysfunction. Reproduced here is the case of a 75-year-old male with current exertional dyspnoea and a history of percutaneous coronary interventional therapy. Wall motion analysis revealed no exercise-induced wall motion abnormality in either view (A, B). The measured mitral flow pattern and tissue Doppler was consistent with that of delayed relaxation (C) and E/E’ increased from 14 at rest to 16 with exercise [127]. Similarly, hyperechoic b-lines that arise in the lung from transudated fluid (D) that can be detected in HFpEF patients with dyspnoea, with good prognostic power [128]