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
Reference limits and partition values of left ventricular size
MEN
WOMEN
Reference
Mildly
Moderately
Severely
Reference
Mildly
Moderately
Severely
Range
Abnormal
Abnormal
Abnormal
Range
Abnormal
Abnormal
Abnormal
LV dimension
LV diastolic diameter, cm
4.2–5.8
5.9–6.3
6.4–6.8
≥6.9
3.8–5.2
5.3–5.6
5.7–6.1
≥6.2
LV diastolic diameter/BSA, cm/m2
2.2–3.0
3.1–3.3
3.4–3.6
≥3.7
2.3–3.1
3.2–3.4
3.5–3.7
≥3.8
LV systolic diameter
2.5–4.0
4.1–4.3
4.4–4.5
≥4.6
2.2–3.5
3.6–3.8
3.9–4.1
≥4.2
LV systolic diameter/BSA, cm/m2
1.3–2.1
2.2–2.3
2.4–2.5
≥2.6
1.3–2.1
2.2–2.3
2.4–2.6
≥2.7
LV volume
LV diastolic volume, mL
62–150
151–174
175–200
≥201
46–106
107–120
121–130
≥131
LV diastolic volume/BSA, mL/m2
34–74
75–89
90–100
≥101
29–61
62–70
71–80
≥81
LV systolic volume, mL
21–61
62–73
74–85
≥86
14–42
43–55
56–67
≥68
LV systolic volume/BSA, mL/m2
11–31
32–38
39–45
≥46
8–24
25–32
33–40
≥41
LV Mass
Reference limits and values and partition values of left ventricular mass
MEN
WOMEN
Reference
Mildly
Moderately
Severely
Reference
Mildly
Moderately
Severely
Range
Abnormal
Abnormal
Abnormal
Range
Abnormal
Abnormal
Abnormal
Linear Method
LV mass, g
88–224
225–258
259–292
≥293
67–162
163–186
187–210
≥211
LV mass/BSA, g/m2
49–115
116–131
132–148
≥149
43–95
96–108
109–121
≥122
Relative wall thickness, cm
0.24–0.42
0.43–0.46
0.47–0.51
≥0.52
0.22–0.42
0.43–0.47
0.48–0.52
≥0.53
Septal thickness, cm
0.6–1.0
1.1–1.3
1.4–1.6
≥1.7
0.6–0.9
1.0–1.2
1.3–1.5
≥1.6
Posterior wall thickness, cm
0.6–1.0
1.1–1.3
1.4–1.6
≥1.7
0.6–0.9
1.0–1.2
1.3–1.5
≥1.6
2D Method
LV mass, g
96–200
201–227
228–254
>255
66–150
151–171
172–182
>193
LV mass/BSA, g/m2
50–102
103–116
117–130
≥131
44–88
89–100
101–112
≥113
LV geometry
Reference limits and values and partition values of left ventricular geometry
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
Reference limits and values and partition values of left ventricular function
*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 parameters, references grouping by age
Echocardiographic reference ranges for normal cardiac Doppler data: results from the NORRE Study
Parameters
20–40 years
40–60 years
>60 years
P
Mean±SD
95% CI
Mean±SD
95% CI
Mean±SD
95% CI
E-wave velocity (m/s)
0.82 ± 0.16
0.53–1.22
0.75 ± 0.17
0.46–1.13
0.70 ± 0.16
0.39–1.03
<0.001
A-wave velocity (m/s)
0.50 ± 0.13
0.30–0.87
0.62 ± 0.15
0.37–0.97
0.77 ± 0.16
0.40–1.04
<0.001
E-wave deceleration time (ms)
178 ± 43
105–269
187 ± 45
114–288
208 ± 62
114–385
<0.001
E/A ratio
1.71 ± 0.52
0.89–3.18
1.24 ± 0.39
0.71–2.27
0.98 ± 0.29
0.53–1.80
<0.001
Septal e' wave (cm/s)
12.1 ± 2.5
8.0–17.0
9.8 ± 2.6
5.0–16.0
7.6 ± 2.3
3.0–13.0
<0.001
Septal a' wave (cm/s)
8.5 ± 1.7
5.3–12.0
9.8 ± 2.0
6.9–14.0
10.5 ± 1.7
7.0–14.0
<0.001
Lateral e' wave (cm/s)
16.4 ± 3.4
10.0–23.0
12.5 ± 3.0
6.0–18.0
9.6 ± 2.8
4.0–17.0
<0.001
Lateral a' wave (cm/s)
8.2 ± 2.2
5.0–13.0
9.4 ± 2.6
5.0–15.0
10.6 ± 2.9
6.0–17.0
<0.001
Average septal and lateral e' wave (cm/s)
14.3 ± 2.7
9.1–19.5
11.1 ± 2.5
6.0–16.0
8.6 ± 2.3
3.5–15.0
<0.001
Septal E/e'
6.9 ± 1.6
4.4–10.6
8.1 ± 2.3
4.3–13.2
9.7 ± 2.8
5.0–16.9
<0.001
Lateral E/e'
5.1 ± 1.3
3.1–8.5
6.3 ± 2.2
3.7–12.0
7.8 ± 2.2
4.2–12.8
<0.001
Average septal and lateral E/e'
5.8 ± 1.3
3.6–9.1
7.0 ± 2.1
4.2–11.5
8.5 ± 2.2
4.6–13.5
<0.001
Average E/e'
5.6 ± 1.1
3.7–7.9
6.8 ± 1.8
4.0–11.6
8.3 ± 2.2
4.4–14.8
<0.001
P differences between groups according to age category (one-way ANOVA).
Most important cut-off values for diastolic parameters
Parameter
Cut-off value
TR Vmax
> 2.8m/s
é septal
< 7 cm/s
é lateral
< 10cm/s
E/é
>14
LAVi
> 34ml/m²
LA Reservoir Strain
< 18%
Grading diastolic function
Criteria for grading of LV diastolic dysfunction according to level of filling pressure and mitral flow velocities