Systolic Function & 3D/4D

Where on an ECG does IVCT & Systole Occur

Right after the QRS complex

Where on an ECG does mechanical systole occur

After IVCT (after QRS) to after the T wave

Measures of cardiac function

• SV

• EF

• CO

• SW

• GLS

• GRS

• E/e’

• Dp/dt

• Time constant of ventricular relaxation

Stroke volume equations

• EDV - ESV

• 0.785 LVOT Diameter² * LVOT VTI

Normal Stroke Volume

70 - 110 mL/beat

CO equation & normal value

• SV * HR

• 4 - 8 L/min

Measures of regional LV function

• visual

• Strain

• TDI Strain rate

Measures of LV global systolic function

• EF

• GLS Average

• TEI index/LIMP

• Visual

EF Equations

• (EDV - ESV) / EDV

Normal LVEF with biplane

54 - 74

Normal EF Values

Fractional Shortening equation & normal value

• (LVIDd - LVIDs)*100 / LVIDd

• 25-45%

Is it ok for the LV to be foreshortened when obtaining 3D volume?

Yes, as long as the whole LV is in view!

What is LV mass?

The total weight of the myocardium; obtained by (myocardium volume * density of cardiac muscle)

Normal LV mass value

66 - 200g

Draw the LV regional function bullseye

Grading of LV regional dysfunction

• 1 = normal/hyperkinetic

• 2 = hypokinetic

• 3 = a kinetic

• 4 = dyskinetic

• 5 = aneurysmal

Stress echo may reveal coronary artery stenosis depending on the regional _________.

Coronary flow reserve

Walls perfused by the LAD

• A4C:

  • IVS (inferoseptal)

  • Apex

  • Anterolateral

• A3C

  • Anteroseptal

  • Apex

  • Apical inferolateral

• A2C

  • Anterior

  • Apex

  • Apical inferior

Walls perfused by the RCA

• RV

• A4C

  • Base & mid IVS (inferoseptal)

• A3C

  • base & mid inferolateral

• A2C

  • Base & mid inferior

Walls perfused by the CX

• A4C

  • Anterolateral wall

• A3C

  • Base & mid inferolateral