Đánh giá chức năng thất trái

M-Mode
Evaluate wall contractility (wall thickness, systolic wall thickening, systolic wall motion)
B -"bump" or "notch" of mitral valve indicates increased LVEDP ≥15 mm Hg
B "bump" or "notch" tricuspid valve indicates increased RVEDP ≥9 mm Hg
Mitral valve E-point to septal separation > 20 mm indicates an ejection fraction of < 30%
Premature closure of the mitral valve (when the C point of the mitral valve occurs on or before the onset of the QRS complex)
Premature opening of the aortic valve (when the aortic valve opens on or before the onset of the QRS complex)
M-mode parameters
Ventricular end-diastolic dimension : 37 to 56 mm
Ventricular end-systolic dimension : 26 to 36 mm
Left ventricular diastolic IVS thickness : 7 to 11 mm
IVS excursion : 6 to 11 mm
IVS % thickening : 27 to 70%
Left ventricular posterior diastolic wall thickness : 7 to 11 mm
LVPW excursion : 9 to 14 mm
LVPW% thickening : 25 to 80%
Percent fractional shortening : 28 to 41%
Ejection fraction : 48 to 78%
PEP/LVET :< 0.42
Mean Vcf : 1.0 to 1.9 Vcf
Stroke volume : 75 to 100 cc
Cardiac output : 4 to 8 L/min
Cardiac index : 2. 4 to 4. 2 L/min/m2
Left ventricular mass : ≤ 294 gm in men, ≤ 198 gm in women
Left ventricular mass index : < 134 gm m2 in men, < 110 gm m2 in women
Mitral valve E-F slope : 70 to 150 mm/sec
Mitral valve E-point septal separation : ≤ 7 mm
2-D
Determine left ventricular function with qualitative visualization of left ventricular function
Determine segmental wall motion abnormalities
Determine ejection fraction (Simpson's disc or area-length method)
Determine fractional area change (normal range: 36 to 64%)
Determine the descent of the base (≥ 10 mm predicts a normal ejection fraction)
Doppler
Evaluate aortic flow velocity tracing
Determine flow velocity integral
Determine stroke-volume
Determine cardiac output
Determine change in pressure over time (dP/dt)
Left Ventricular Function Doppler Parameters
Flow velocity integral
Normal aortic valve: 18 to 22 cm
Normal mitral valve: 10 to 13 cm
Dp/dt
Normal >1200 mmHg/sec
Borderline 1000 to 1200 mmHg/sec
Abnormal <1000 mmHg/sec
Left ventricular function (aortic flow velocity tracing)
Peak flow velocity : 72 to 120 (mean 92)
Acceleration time (msec) : 83 to 118 ( 98 )
Average acceleration (cm/sec) : 735 to 1318 ( 955 )
Deceleration time (msec) : 170 to 230 ( 197 )
Average deceleration (cm/sec2) : 355 to 630 ( 473 )
Ejection time (msec) : 255 to 325 ( 294 )