Introduction .– Echocardiography is a key consideration in the management of diastolic heart failure, the measurement of ejection fraction of left ventricle is therefore fundamental.

Objective .– In this work we propose to outline the epidemiological, clinical and echocardiographic findings in patients with diastolic heart failure.

Patients and methods .– Our retrospective study included 44 patients with clinical and echocardiographic evidence of diastolic heart failure with ejection fraction ≥ 45%, who were hospitalized during the period from November 2006 to March 2010 at the therapeutic unit of heart failure of Cardiology, CHU Ibn Rochd, Casablanca, Morocco.

Results .– Of a total of 1200 patients hospitalized with heart failure in unit of heart failure. 3.6% had diastolic heart failure with a male predominance (61%), average age of 65.4 years. The dyspnea was constant (95.2%), patients had heart failure NYHA class I (6%), NYHA class II (37.9%), NYHA class III (44%) and NYHA class IV (7%). Doppler echocardiography was performed in all patients, ejection fraction was measured by the method of Simpson biplane and was ≥ 45% in 44 patients who all had elevated filling pressures of left ventricle. Filling pressures of left ventricle were assessed by the study of mitral inflow by pulsed-wave Doppler, with restrictive filling in 68.1% among patients with E/A ratio > 2, deceleration time < 150 ms and time isovolumic relaxation < 60 ms, the mitral flow was normal with E/A ratio: 1 to 2 in 31.8% of cases. In mitral inflow and annulus tissue Doppler: The E/Ea ratio was ≥ 15 in 88.6% of cases and E/Ea ratio ≥ 9 and ≤ 14 in 11.3% of patients and in this case we have had recourse to the analysis of pulmonary venous flow with an Ar–A duration ≥ 30 ms, the measurement of left atrium volume was ≥ 34 ml/m ² , and the measurement of pulmonary artery systolic pressure was > 35mmHg.

Conclusion .– Doppler echocardiography in diastolic heart failure measures filling pressures of the left ventricle and also beneficial to the etiologic and prognostic and follow-up.