A 72 year old woman with chronic hypertension presents with progressive dyspnea. An echocardiogram shows concentric LVH with an ejection fraction of 70%, and a left atrial volume of 100 ml (BSA = 2.0m2). Doppler study shows an E/A ratio of 1.0 and a lateral E/e’ of 18. Patient has mild TR and a TR velocity recorded in the parasternal short axis view has a peak velocity of 2 m/s. Mean RA pressure is estimated at 5 mmHg. How would you interpret these findings?
a) The patient has impaired LV relaxation with elevated mean LA pressure but with normal PA systolic pressure.
b) The patient has impaired LV relaxation with elevated mean LA pressure. Cannot estimate PA systolic pressure since the TR recording may be inadequate due to either an incomplete signal or the parasternal sampling location.
c) The patient has normal diastolic function and PA pressure.
d) The patient has impaired LV relaxation with normal mean LA pressure and PA systolic pressure.
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