1 / 55

Echocardiography

Echocardiography. Left Ventricular Systolic Function. Basic Principle. Basic Principle. Systole The period of the cardiac cycle from the closure of the mitral valve to the closure of the aortic valve. Basic Principle. Phases IVCT Ejection phase. Basic Principle. IVCT

Patman
Download Presentation

Echocardiography

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Echocardiography Left Ventricular Systolic Function

  2. Basic Principle

  3. Basic Principle Systole The period of the cardiac cycle from the closure of the mitral valve to the closure of the aortic valve.

  4. Basic Principle • Phases • IVCT • Ejection phase

  5. Basic Principle IVCT • Time from MV closure to AV opening

  6. Basic Principle • Mitral valve opens when the LAP is greater than LVP. • Mitral valve closes when LVP is greater than LAP. • Aortic valve opens when LVP is greater than aortic pressure. • Aortic valve closes when the aortic pressure is greater than LVP.

  7. Basic Principle

  8. Evaluation of LV Systolic Function • Evaluation • M- mode • Two Dimensional • Doppler

  9. Evaluation of LV Systolic Function

  10. Evaluation of LV Systolic Function ESD = LVIDs EDD = LVIDd FS= LVIDd - LVIDs LVIDd

  11. Evaluation of LV Systolic Function EF = LVIDd3 – LVIDs3 LVIDd3

  12. Evaluation of LV Systolic Function Single Plane Ellipsoid Uses the length and area A of a single long-axis view. Left ventricular volume is calculated assuming an ellipsoid shape as: V = 8 A2 3 p L

  13. Evaluation of LV Systolic Function A is measured by tracing the endocardial borders.

  14. Evaluation of LV Systolic Function Hemi-cylindrical Hemi-ellipsoid Model Assumes: Base of ventricle = cylinder Apex of ventricle = ellipsoid Volume is calculated using a long axis length L and cross-sectional area Am of an orthogonal short-axis view at the mid-papillary muscle. V = (Am) L/2 + 2/3 (Am) L/2 V = 5/6 AL (Bullet Formula)

  15. Evaluation of LV Systolic Function

  16. Evaluation of LV Systolic Function In the presence of regional wall motion abnormalities all the above methods will be less accurate, since if the region of abnormal wall motion is included in the dimension or area measurements, volumes will be overestimated.

  17. Evaluation of LV Systolic Function The apical biplane methods are more robust in this setting, using summation of a series of disks from apex to base (often called Simpson’s Rule).

  18. Evaluation of LV Systolic Function The ASE (American Society of Echocardiography) recommends use of biplane apical views with a modified Simpson’s rule approach..

  19. Evaluation of LV Systolic Function For this method, endocardial borders are traced in apical four-chamber and two-chamber views and are used to define a series of orthogonal diameters (a and b) as follows: V = (p ) S ai bi x (L) 4 20 Using 20 disk for i = 1 to i = 20 This calculation is done by computer software.

  20. Evaluation of LV Systolic Function

  21. Evaluation of LV Systolic Function

  22. Evaluation of LV Systolic Function

  23. Evaluation of LV Systolic Function

  24. Evaluation of LV Systolic Function

  25. Evaluation of LV Systolic Function

  26. Evaluation of LV Systolic Function

  27. Evaluation of LV Systolic Function

  28. Evaluation of LV Mass This is done by tracing the epicardial to calculate the total ventricular volume and the endocardial border to calculate chamber volume. LV mass = 1.05 (total volume – chamber volume)

  29. Evaluation of LV Mass LV Total Area

  30. Evaluation of LV Mass LV Cavitary Area

  31. Evaluation of LV Mass Length

  32. Evaluation of LV Mass Total volume= Total area x length Chamber volume = Chamber area x Length Myocardial volume = Total volume – Chamber volume LV mass = Myocardial volume x density LV mass = Myocardial volume x 1.05

  33. Evaluation of LV Mass

  34. Doppler Stroke Volume Calculation

  35. Doppler Stroke Volume Calculation • Assumption used for measuring SV using Doppler are: • Accurate cross-sectional flow area measurement. • Laminar Flow. • Spatial ‘flat’ flow velocity profile. • Parallel intercept angle between Doppler beam and • direction of blood flow. • 5. Velocity and diameter measurements are made at the • same anatomic site.

  36. Doppler Stroke Volume Calculation • Measurement Location • Ascending aorta • Aortic valve leaflet tips • LVOT

  37. Doppler Stroke Volume Calculation • Ascending aorta • Measure • Diameter in PLAX • VTI from an apical or suprasternal approach with • PWD.

  38. Doppler Stroke Volume Calculation • Ascending aorta • Measure • Diameter at Sinotubular junction • VTI from apical or suprasternal approach using • CWD.

  39. Doppler Stroke Volume Calculation • Leaflet Tips • Diameter in PLAX at leaflet tip • VTI from an apical or suprasternal approach • with PWD.

  40. Doppler Stroke Volume Calculation • LVOT • Diameter measured in PLAX , immediately adjacent to the aortic valve in midsystole from the septal endocardium to the leading edge of the anterior mitral valve leaflet.

  41. Doppler Stroke Volume Calculation LVOT PWD is used form an apical approach to record the velocity curve, using the closing click of the aortic valve to ensure that the sample volume is located at the annulus.

  42. Doppler Stroke Volume Calculation

  43. Doppler Stroke Volume Calculation

  44. Doppler Stroke Volume Calculation

  45. Doppler Stroke Volume Calculation

  46. Doppler Stroke Volume Calculation

  47. Doppler Stroke Volume Calculation

  48. Evaluation of LV Systolic Function • The other Doppler measurements that can be used to measure LV systole function are • Peak velocity • Mean acceleration • Acceleration Time • Deceleration Time • Ejection time • Mean deceleration

  49. Evaluation of LV Systolic Function Ejection Time Deceleration Time Acceleration Time Mean Acceleration Peak Acceleration Peak velocity

  50. Evaluation of LV Systolic Function

More Related