ECHO 2013 / Quantifying the Left Heart (LV and LA) Basic and Advanced Measurements

Linear Measurements - TEE

•Recommended for LV dimension are midesophageal or transgastric 2- chamber (3-chamber often foreshortened) at junction of basal and middle 1/3 of ventricle

•Recommended for wall thickness is transgastric at 0-30 ◦, mid-ventricular short-axis view.

Linear Measurements - TEE

Linear Measurements - TEE

LV Size Reference Values

Calculation of LV Mass

•3 methods based on 2D measurements:

1)Linear (prolate ellipse)

2)Area-length method

3)Truncated Ellipsoid method

4)Biplane Simpson’s

•All subtract the LV cavity volume from total volume enclosed by epicardium to obtain LV muscle volume, then multiple by myocardial density

LV Mass

Validated on autopsy and animal models

LV Mass

•Biplane Simpson’s

-Recommended in cases of extensive regional wall motion abnormalities

-dependent on good definition of epicardial as well as endocardial borders, which is technically difficult

LV Mass

•TEE also accurate

-approximately 6 g/m2 larger than

TEE measurements

•RWT: (2x PWd)/LVIDd

-delineate type of hypertrophy

-≥ 0.42 = concentric, < 0.42 eccentric

LV Mass Reference Values