Measurement of in-vivo diastolic function indexes has required cardiac catheterization. Analysis of Doppler echocardiographic transmitral flow contours using a kinematic paradigm holds promise in elimination of cardiac catheterization as a requirement for quantitative diastolic function characterization. The paradigm suggests that novel, kinematic indexes which characterize diastolic function can be extracted from the Doppler velocity profile (DVP). This article reviews the role of a kinematic modeling strategy. Topics covered include: the role of the heart as a suction pump, automated solution of the ‘inverse problem’ of diastole, the relationship of ‘dissynchronous relaxation’ of the ventricle to the Doppler waveform, prediction of LVEDP from the DVP and the causal relation of the third (S3) and fourth (S4) heart sounds to the Doppler E and A-waves.
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