Figure 1.

Example of bedside measurement of spectral Doppler velocities (cm/s) in the apical 4-chamber view in a 82 years-old woman hospitalized for new-onset congestive heart failure with preserved left ventricular systolic function related to longstanding hypertension. At presentation, the score of Boston criteria was 10 and B-type natriuretic peptide concentration 460 pg/ml. Bedside Doppler echocardiography performed before unloading therapy showed a left ventricular ejection fraction of 67% (upper part); peak E mitral velocity between the tips of mitral leaflets was 101 cm/s, spectral tissue Doppler peak early diastolic E' velocities at the septal (middle part) and lateral corner of mitral annulus (lower part) were 6 and 9 cm/s, respectively. The patient experienced a complete relief of symptoms and signs of pulmonary congestion under unloading therapy. Invasive left ventricular end-diastolic pressure recorded after clinical stabilization was 14 mm Hg.