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As confusing as defining the lower limit of “normal” may be, defining the upper limit is much more difficult, for both technical and physiological reasons. Taking the question from the end, measurement of LVEF can be accomplished by a .
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E/e’: > 14 is rare in normal individuals Change in mitral inflow with Valsalva: 50% change in E/A o highly specific for increased LV filling pressures o supports diagnosis of diastolic dysfunction o requires continuous recording of the Doppler signal during 10 seconds of Valsalva Difference in duration between pulmonary vein Ar ve.
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