Systolic Function: Difference between revisions
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==The Left | ==The Left Ventricle== | ||
Each echocardiogram | Each echocardiogram should include an evaluation of the LV dimensions, wall thicknesses and function. | ||
Several (read: different) measurements have to be performed from different views to asses a good estimate of LV function. | |||
==Left ventricular systolic function== | ==Left ventricular systolic function== | ||
===Left ventricular function=== | ===Left ventricular function=== | ||
{| class="wikitable" cellpadding="0" cellspacing="0" border="0" width="700px" | |||
|- | |||
!rowspan="2"| | |||
!colspan="4"|Women | |||
!colspan="4"|Men | |||
|- | |||
|align="center"|'''Reference range''' | |||
|align="center"|'''Mildly abnormal''' | |||
|align="center"|'''Moderately abnormal''' | |||
|align="center"|'''Severely abnormal''' | |||
|align="center"|'''Reference range''' | |||
|align="center"|'''Mildly abnormal''' | |||
|align="center"|'''Moderately abnormal''' | |||
|align="center"|'''Severely abnormal''' | |||
|- | |||
|colspan="9"|'''Linear method''' | |||
|- | |||
|Wallmotion score index | |||
|align="center"|1.0 | |||
|align="center"|1.0-1.5 | |||
|align="center"|1.5-2.0 | |||
|align="center"|<2.0 | |||
|align="center"|1.0 | |||
|align="center"|1.0-1.5 | |||
|align="center"|1.5-2.0 | |||
|align="center"|<2.0 | |||
|- | |||
|Endocardial fractional shortening, % | |||
|align="center"|27-45 | |||
|align="center"|22-26 | |||
|align="center"|17-21 | |||
|align="center"|≤16 | |||
|align="center"|25-43 | |||
|align="center"|20-24 | |||
|align="center"|15-19 | |||
|align="center"|≤14 | |||
|- | |||
|Midwall fractional shortening, % | |||
|align="center"|15-23 | |||
|align="center"|13-14 | |||
|align="center"|11-12 | |||
|align="center"|≤10 | |||
|align="center"|14-22 | |||
|align="center"|12-13 | |||
|align="center"|10-11 | |||
|align="center"|≤10 | |||
|- | |||
|colspan="9"|'''2D Method''' | |||
|- | |||
!Ejection fraction, % | |||
!≥55 | |||
!45–54 | |||
!30–44 | |||
!<30 | |||
!≥55 | |||
!45–54 | |||
!30–44 | |||
!<30 | |||
|- | |||
|colspan="9"|'''Doppler Method''' | |||
|- | |||
|Myocard performance index | |||
|align="center"|<0.40 | |||
| | |||
| | |||
| | |||
|align="center"|<0.40 | |||
| | |||
| | |||
| | |||
|- | |||
|dP/dt | |||
|align="center"|>1100 | |||
| | |||
| | |||
|align="center"|<500 | |||
|align="center"|>1100 | |||
| | |||
| | |||
|align="center"|<500 | |||
|- | |||
|colspan="9"|'''Bold values:''' Recommended and best validated.<cite>1</cite> | |||
*Click [http://csecho.ca/cardiomath/?eqnHD=echo&eqnDisp=lvefdm '''here'''] for ejection fraction determination by Teichholz 'formula | |||
*Click [http://csecho.ca/cardiomath/?eqnHD=echo&eqnDisp=dpdtlvc '''here'''] for calculating dP/dt | |||
*Click [http://csecho.ca/cardiomath/?eqnHD=echo&eqnDisp=mpiteilv '''here'''] for calculation myocardial performance index | |||
*Click [http://csecho.ca/cardiomath/?eqnHD=echo&eqnDisp=lvfs '''here'''] to calculate fractional shortening. | |||
|} | |||
===Left ventricular function by Strain Rate Imaging=== | ===Left ventricular function by Strain Rate Imaging=== | ||
{| class="wikitable" cellpadding="0" cellspacing="0" border="0" width="700px" | |||
|- | |||
!colspan="6"|Comparison of segmental Values (mean and SD) for LV strain (TQ<3), with a repeated measures design.<cite>2</cite> | |||
|- | |||
! | |||
!All Levels | |||
!Apical | |||
!Mid | |||
!Basal | |||
!pValue (Levels) | |||
|- | |||
|All Walls | |||
|align="center"| -18.6±5.1 | |||
|align="center"| -20.2±5.6 | |||
|align="center"| -18.7±3.3 | |||
|align="center"| -17.0±5.2 | |||
|align="center"|<0.0001 | |||
|- | |||
|Anterior | |||
|align="center"| -19.5±4.2 | |||
|align="center"| -19.4±5.4 | |||
|align="center"| -18.8±3.4 | |||
|align="center"| -20.1±4.0 | |||
|align="center"|0.001 | |||
|- | |||
|Anteroseptal | |||
|align="center"| -18.8±4.2 | |||
|align="center"| -18.8±5.9 | |||
|align="center"| -19.4±3.2 | |||
|align="center"| -18.3±3.5 | |||
|align="center"|0.001 | |||
|- | |||
|Inferior | |||
|align="center"| -20.0±4.5* | |||
|align="center"| -22.5±4.5 | |||
|align="center"| -20.4±3.5 | |||
|align="center"| -17.1±3.9 | |||
|align="center"|<0.0001 | |||
|- | |||
|Lateral | |||
|align="center"| -18.3±4.7 | |||
|align="center"| -19.2±5.4 | |||
|align="center"| -18.1±3.5 | |||
|align="center"| -17.3±5.0 | |||
|align="center"|0.06 | |||
|- | |||
|Posterior | |||
|align="center"| -16.3±6.3† | |||
|align="center"| -17.7±6.0 | |||
|align="center"| -16.8±5.0 | |||
|align="center"| -14.5±7.4 | |||
|align="center"|<0.0001 | |||
|- | |||
|Septal | |||
|align="center"| -18.3±5.3 | |||
|align="center"| -22.3±4.8 | |||
|align="center"| -18.7±3.0 | |||
|align="center"| -13.7±4.0 | |||
|align="center"|<0.0001 | |||
|- | |||
|p (walls) | |||
|align="center"|<0.0001 | |||
|align="center"|<0.0001 | |||
|align="center"|<0.0001 | |||
|align="center"|<0.0001 | |||
|- | |||
|colspan="6"|*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. | |||
|} | |||
==References== | ==References== | ||