Table 2.

Summary of echocardiographic indices and their role in diagnosis of HFpEF and HFrEF

Evaluation systolic function		Interpretation
LVEF	Contour endocardial borders in end-diastole and systole on apical 4 and 2 chamber	Systolic function—preserved in HFpEF [1, 6, 33, 37]
Left ventricular end diastolic volume (LVEDV)	Contour LV endocardium in end diastole	Chamber size—normal or decreased in HFpEF
Global longitudinal strain	Contour endocardial borders in end diastole and systole on apical 4, 3 and 2 chamber	Systolic function—may be decreased in HFpEF [41, 42, 43].
Diastolic function
E′ septum and E′ lateral wall	Tissue Doppler sample volume at septal and lateral basal LV regions	Early diastolic velocity of mitral annular motion—decreased in HFpEF
Mitral flow velocities (E/A)	PW Doppler sample volume at the tips of the mitral valve leaflets to gain peak velocity in early diastole (E wave), peak velocity in late diastole (A wave)	Progressive diastolic dysfunction: delayed relaxation (E/A <0.8), pseudonormalization (E/A 0.8–1.5) and restrictive pattern (E/A ≥2) [39, 40, 44]
E:e′ ratio	Ratio of peak mitral valve inflow velocity during early diastole (E wave) to the average septal/lateral mitral annular early diastolic velocity (e′)	Increased in HFpEF and when >15, diagnostic of increased LV filling pressures [39, 45, 46]
Peak TR jet velocity	Peak velocity through tricuspid valve during systole, measured by using continuous wave (CW) Doppler aligned over colour flow to obtain the highest velocity	TR velocity >2.8 m/s is an indirect marker of LV diastolic dysfunction and indicates increased pulmonary artery systolic pressure (PASP) [39]
LAVI, or the LA maximal volume indexed to body surface area	Measured using two orthogonal long-axis views	Increased in HFpEF [39, 47]
LVH [LVMI, regional wall thickness (RWT)]	LVMI uses 2-dimensional measurements in one view while RWT allows classification into concentric (>0.42) or eccentric hypertrophy (≤0.42).	May be increased in HFpEF