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.

LV size
Parameter Men Women
Mean ± SD 2-SD range Mean ± SD 2-SD range
LVED diameter (mm) 50.2 ± 4.1 42.0 - 58.4 45.0 ± 3.6 37.8 - 52.2
LVESD diameter (mm) 32.4 ± 3.7 25.0 - 39.8 28.2 ± 3.3 21.6 - 34.8
LVED Volume (biplane, mL) 106 ± 22 62 - 150 76 ± 15 46 - 106
LVES Volume (biplane, mL) 41 ± 10 21 - 61 28 ± 7 14 - 42
LVED Volume (BSA index, mL/m²) 54 ± 10 34 - 74 45 ± 8 29 - 61
LVES Volume (BSA index, mL/m²) 21 ± 5 11 - 31 16 ± 4 8 - 24
LV Mass
Parameter Men Women
LV mass (g) 88 - 224 67 - 162
LV mass/BSA (g/m²) 49 - 115 43 - 95
Relative Wall thickness (mm) 24 - 42 22 - 42
Septal thickness (mm) 6 - 10 6 - 9
Posterior thickness (mm) 6 - 10 6 - 9
LV geometry
Relative wall thickness and left ventricular mass estimated by LV cavity dimension and wall thickness at end-diastole. Click here for calculation.
Relative wall thickness Left ventricular mass index
Women Men
Normal geometry ≤0.42 ≤95 ≤115
Concentric remodeling >0.42 ≤95 ≤115
Concentric hypertrophy >0.42 >95 >115
Eccentric hypertrophy ≤0.42 >95 >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
Parameter | Men | Women | ||||||
---|---|---|---|---|---|---|---|---|
Reference range | Mildly abnormal | Moderately abnormal | Severely abnormal | 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 | 1.0 | 1.0-1.5 | 1.5-2.0 | <2.0 |
Endocardial fractional shortening, % | 25-43 | 20-24 | 15-19 | ≤14 | 27-45 | 22-26 | 17-21 | ≤16 |
Midwall fractional shortening, % | 14-22 | 12-13 | 10-11 | ≤10 | 15-23 | 13-14 | 11-12 | ≤10 |
Doppler Method | ||||||||
Myocard performance index | <0.40 | <0.40 | ||||||
dP/dt | >1100 | <500 | >1100 | <500 |
LV Ejection fraction
Parameter | Normal | Mildly abnormal | Moderately abnormal | Severely abnormal |
---|---|---|---|---|
LVEF (%) Men | 72 – 52 | 51 – 41 | 40 – 30 | <30 |
LVEF (%) Women | 74 – 54 | 53 – 41 | 40 – 30 | <30 |
Eyeballing LVEF
LV Strain
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. |
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
Measurement | Age 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 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. |
Grading diastolic function
Grading LV diastolic function with normal LVEF.
Estimation LV Filling Pressures with depressed LVEF or normal LVEF with diastolic dysfunction.
References
JASE 2015 Jan;28(1):1-39.e14
Eur Heart J Cardiovasc Imaging. 2016 Dec;17(12):1321-1360
JACC Cardiovasc Imaging. 2009 Jan;2(1):80-4