Table 2.

Differential Diagnoses of HFpEF and Their Echocardiographic Clues

Differential Diagnosis	Echocardiographic Clues
Hypertrophic	Asymmetric hypertrophy, ↑↑LV wall thickness,
cardiomyopathy	LVOT obstruction, SAM
Restrictive	Small LV cavity, ↑LV wall thickness, Sparkling
cardiomyopathy	myocardium, Apical sparing, Severely reduced tissue Doppler, PE
Pulmonary arterial	↑RVSP with no sign of elevated LV filling
hypertension	pressure, Isolated right heart dilation, PA dilation, RVOT Doppler midsystolic notch
Constrictive pericarditis	Pericardial thickening, Septal bounce, annulus paradoxus and annulus reversus, ↑Respiratory variation in mitral/tricuspid flow, Absence of IVC collapse
Valvular heart disease	Morphological valvular abnormalities, Color Doppler
Coronary artery disease	Regional wall motion abnormality and thinning
Chronic thromboembolic	↑RVSP with no sign of elevated LV filling
pulmonary hypertension	pressure, Isolated right heart dilation, PA dilation, RVOT Doppler midsystolic notch
High output heart failure	↑Doppler-derived cardiac output

IVC, inferior vena cava; LV, left ventricular; LVOT, left ventricular outflow obstruction; PA, pulmonary artery; RVSP, estimated right ventricular systolic pressure; PE, pericardial effusion; RVOT, right ventricular outflow; SAM, systolic anterior motion of the mitral valve; and other abbreviations as in Table 1.