Left Ventricle

Left ventricle dimensions

Each echocardiogram include an assessment of LV dimensions, describing wall thickness and function. Good measurements are essential and may have implications for therapy. LV dimensions must be measured in PLAX, end-diastolic and end-systolic and valves (MV and AOV) are closed. The measurement is situated in the basal part of the LV by the chordae.

 

LVEDd

 

Normal values LV size for Men
Parameter MALE
Mean ± SD 2-SD range
LVED diameter (mm) 50.2 ± 4.1 42.0 – 58.4
LVESD diameter (mm) 32.4 ± 3.7 25.0 – 39.8
LVED Volume (biplane, mL) 106 ± 22 62 – 150
LVES Volume (biplane, mL) 41 ± 10 21 – 61
LVED Volume (BSA index, mL/m²) 54 ± 10 34 – 74
LVES Volume (BSA index, mL/m²) 21 ± 5 11 – 31

 

 

Normal values LV size for Women
Parameter FEMALE
Mean ± SD 2-SD range
LVED diameter (mm) 45.0 ± 3.6 37.8 – 52.2
LVESD diameter (mm) 28.2 ± 3.3 21.6 – 34.8
LVED Volume (biplane, mL) 76 ± 15 46 – 106
LVES Volume (biplane, mL) 28 ± 7 14 – 42
LVED Volume (BSA index, mL/m²) 45 ± 8 29 – 61
LVES Volume (BSA index, mL/m²) 16 ± 4 8 – 24

 

 

Normale values LV mass for men
Parameter MALE
LV mass (g) 88 – 224
LV mass/BSA (g/m²) 49 – 115
Relative Wall thickness (mm) 24 – 42
Septal thickness (mm) 6 – 10
Posterior thickness (mm) 6 – 10

 

 

Normale values LV mass for women
Parameter FEMALE
LV mass (g) 67 – 162
LV mass/BSA (g/m²) 43 – 95
Relative Wall thickness (mm) 22 –  42
Septal thickness (mm) 6 – 9
Posterior thickness (mm) 6 – 9  

 

 

LV Geometry for man
Relative Wall Thickness >0.42 Concentric remodeling Concentric hypertrophy
>0.42 Normal geometry Eccentric hypertrophy
Male (gm/m²) ≤115 >115
 
LV Geometry for woman
Relative Wall Thickness >0.42 Concentric remodeling Concentric hypertrophy
>0.42 Normal geometry Eccentric hypertrophy
Female (gm/m²) ≤95 >95

 

Left ventricle systolic function

Each echocardiogram include an assessment of LV dimensions, describing wall thickness and function. It is essential to make multiple measurements for a proper assessment of LV function.

 

 

Left Ventricle Ejection Fracion

  Normal Mildly abnormal Moderately abnormal Severely abnormal
LVEF (%)   MALE 52 – 72 41 – 51 30 – 40 <30
LVEF (%)   FEMALE 54 – 74 41 – 53 30 – 40 <30

 

3DEF

 

Left Ventricle Function parameters for Men
parameter Men
Reference range Mildly abnormal Moderately abnormal Severely abnormal
Linear method
Wallmotion score index 1.0 1.0-1.5 1.5-2.0 <2.0
Endocardial fractional shortening, % 25-43 20-24 15-19 ≤14
Midwall fractional shortening, % 14-22 12-13 10-11 ≤10
Doppler Method
Myocard performance index <0.40      
dP/dt >1100     <500

 

 

Left Ventricle Function parameters for Women
parameter Women
Reference range Mildly abnormal Moderately abnormal Severely abnormal
Linear method
Wallmotion score index 1.0 1.0-1.5 1.5-2.0 <2.0
Endocardial fractional shortening, % 27-45 22-26 17-21 ≤16
Midwall fractional shortening, % 15-23 13-14 11-12 ≤10
Doppler Method
Myocard performance index <0.40      
dP/dt >1100     <500

 

 

Left Ventricle Function normal values for strain rate imaging
Parameter All Levels Apical Mid Basal pValue (Levels)
All Walls -18.6±5.1 -20.2±5.6 -18.7±3.3 -17.0±5.2 <0.0001
Anterior -19.5±4.2 -19.4±5.4 -18.8±3.4 -20.1±4.0 0.001
Anteroseptal -18.8±4.2 -18.8±5.9 -19.4±3.2 -18.3±3.5 0.001
Inferior -20.0±4.5* -22.5±4.5 -20.4±3.5 -17.1±3.9 <0.0001
Lateral -18.3±4.7 -19.2±5.4 -18.1±3.5 -17.3±5.0 0.06
Posterior -16.3±6.3† -17.7±6.0 -16.8±5.0 -14.5±7.4 <0.0001
Septal -18.3±5.3 -22.3±4.8 -18.7±3.0 -13.7±4.0 <0.0001
p (walls) <0.0001 <0.0001 <0.0001 <0.0001  
*inferior was significantly different from other walls (p<0.001 except anterior p+0.002), in the comparison of walls at all levels.†Posterior was significantly different from all other walls (p<0.0001). In the comparison oflevels in all walls, each level was significantly different (p <0.0001). LV=left ventricular, TQ=tracking quality.

 

Left ventricle diastolic function

Still a lot remains unclear about the pathophysiology of diastolic heart failure, which still lacks an effective treatment, with a high mortality rate associated with diastolic heart failure over the last decades. Diastolic heart failure is characterized by an increased LV diastolic stiffness. There are some important echocardiographic measurements that should be included in the standard ultrasound examination in order to a properly assessment of the LV stiffness.

 

 

Normal values diastolic parameters
Measurement Age group (y)
16-20 21-40 41-60 >60
IVRT (ms) 50 ± 9 (32-68) 67 ± 8 (51-83) 74 ± 7 (60-88) 87 ± 7 (73-101)
E/A ratio 1.88 ± 0.45 (0.98-2.78) 1.53 ± 0.40 (0.73-2.33) 1.28 ± 0.25 (0.78-1.78) 0.96 ± 0.18 (0.6-1.32)
DT (ms) 142 ± 19 (104-180) 166 ± 14 (138-194) 181 ± 19 (143-219) 200 ± 29 (142-258)
A duration (ms) 113 ± 17 (79-147) 127 ± 13 (101-153) 133 ± 13 (107-159) 138 ± 19 (100-176)
PV S/D ratio 0.82 ± 0.18 (0.46-1.18) 0.98 ± 0.32 (0.34-1.62) 1.21 ± 0.2 (0.81-1.61) 1.39 ± 0.47 (0.45-2.33)
PV Ar (cm/s) 16 ± 10 (1-36) 21 ± 8 (5-37) 23 ± 3 (17-29) 25 ± 9 (11-39)
PV Ar duration (ms) 66 ± 39 (1-144) 96 ± 33 (30-162) 112 ± 15 (82-142) 113 ± 30 (53-173)
Septal e´ (cm/s) 14.9 ± 2.4 (10.1-19.7) 15.5 ± 2.7 (10.1-20.9) 12.2 ± 2.3 (7.6-16.8) 10.4 ± 2.1 (6.2-14.6)
Septal e´/a´ ratio 2.4* 1.6 ± 0.5 (0.6-2.6) 1.1 ± 0.3 (0.5-1.7) 0.85 ± 0.2 (0.45-1.25)
Lateral e´ (cm/s) 20.6 ± 3.8 (13-28.2) 19.8 ± 2.9 (14-25.6) 16.1 ± 2.3 (11.5-20.7) 12.9 ± 3.5 (5.9-19.9)
Lateral e´/a´ ratio 3.1* 1.9 ± 0.6 (0.7-3.1) 1.5 ± 0.5 (0.5-2.5) 0.9 ± 0.4 (0.1-1.7)
Data are expressed as mean ± SD (95% confidence interval). Note that for e´ velocity in subjects aged 16 to 20 years, values overlap with those for subjects aged 21 to 40 years. This is because e´ increases progressively with age in children and adolescents. Therefore, the e´ velocity is higher in a normal 20-year-old than in a normal 16-year-old, which results in a somewhat lower average e´ value when subjects aged 16 to 20 years are considered.
* Standard deviations are not included because these data were computed, not directly provided in the original articles from which they were derived.

 

 

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