Left ventricle

LV dimensions

LV systolic function

LV diastolic function

LV 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

 

LV size

ParameterMenWomen
Mean ± SD2-SD rangeMean ± SD2-SD range
LVED diameter (mm)50.2 ± 4.142.0 - 58.445.0 ± 3.637.8 - 52.2
LVESD diameter (mm)32.4 ± 3.725.0 - 39.828.2 ± 3.321.6 - 34.8
LVED Volume (biplane, mL)106 ± 2262 - 15076 ± 1546 - 106
LVES Volume (biplane, mL)41 ± 1021 - 6128 ± 714 - 42
LVED Volume (BSA index, mL/m²)54 ± 1034 - 7445 ± 829 - 61
LVES Volume (BSA index, mL/m²)21 ± 511 - 3116 ± 48 - 24
  

LV Mass

ParameterMenWomen
LV mass (g)88 - 22467 - 162
LV mass/BSA (g/m²)49 - 11543 - 95
Relative Wall thickness (mm)24 - 4222 - 42
Septal thickness (mm)6 - 106 - 9
Posterior thickness (mm)6 - 106 - 9
 

LV geometry

 
Relative Wall Thickness>0.42Concentric remodelingConcentric Hypertrophy
≤0.42Normal GeometryEccentric Hypertrophy
Women≤95>95
Man≤115>115

LV 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.

LV function

ParameterMenWomen
Reference
range
Mildly
abnormal
Moderately
abnormal
Severely
abnormal
Reference
range
Mildly
abnormal
Moderately
abnormal
Severely
abnormal
Linear method
Wallmotion score index1.01.0-1.51.5-2.0<2.01.01.0-1.51.5-2.0<2.0
Endocardial fractional shortening, %25-4320-2415-19≤1427-4522-2617-21≤16
Midwall fractional shortening, %14-2212-1310-11≤1015-2313-1411-12≤10
Doppler Method
Myocard performance index<0.40<0.40
dP/dt>1100<500>1100<500

LV Ejection fraction

ParameterNormalMildly abnormalModerately abnormalSeverely abnormal
LVEF (%) Men72 – 5251 – 4140 – 30<30
LVEF (%) Women74 – 5453 – 4140 – 30<30

LV Strain

ParameterAll LevelsApicalMidBasalpValue (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±4.00.001
Anteroseptal-18.8±4.2-18.8±5.9-19.4±3.2-18.3±3.50.001
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±5.00.06
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.

LV 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.

LV diastolic function

MeasurementAge group 16-20 (y)Age group 21-40 (y)Age group 41-60 (y)Age group >60 (y)
IVRT (ms)50 ± 9 (32-68)67 ± 8 (51-83)74 ± 7 (60-88)87 ± 7 (73-101)
E/A ratio1.88 ± 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 ratio0.82 ± 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´ ratio2.4*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´ ratio3.1*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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