From the Guidelines
The echocardiogram results indicate completely normal cardiac function, and no intervention is needed as all cardiac parameters are within normal limits, indicating a healthy heart. The heart has a normal sinus rhythm, which is the expected regular heartbeat pattern. The left ventricle, which is the main pumping chamber of the heart, has normal size (5.3 cm) and normal wall thickness (interventricular septum 0.6 cm and posterior wall 0.7 cm). The pumping function is normal with an ejection fraction of 54-60%, which represents the percentage of blood pumped out with each contraction, as supported by the guidelines from the European Society of Cardiology 1. The heart muscle mass is normal at 61 g/m².
Additionally, the diastolic function, which reflects how well the heart relaxes and fills with blood between beats, is normal as indicated by appropriate E/A ratio (1.2), deceleration time (209 ms), and tissue Doppler velocities (E' septal 13.2 cm/s, E' lateral 18.8 cm/s), consistent with the recommendations for the evaluation of left ventricular diastolic function by echocardiography 1. The E/E' ratios (medial 9.2, lateral 6.5) are also within normal range, suggesting normal filling pressures.
Key points to note include:
- Normal E/A ratio and deceleration time, indicating normal diastolic function
- Normal tissue Doppler velocities, further supporting normal diastolic function
- Normal E/E' ratios, suggesting normal filling pressures
- Normal left ventricular size, wall thickness, and ejection fraction, indicating normal systolic function
- Normal heart muscle mass, indicating no evidence of hypertrophy or remodeling.
Overall, the echocardiogram results are consistent with a healthy heart, and no further intervention or monitoring is needed based on these findings, as supported by the most recent guidelines 1.
From the Research
Left Ventricle (LV) Analysis
- The patient's LV chamber size is normal with a Left Ventricular Internal Dimension at end-diastole (LVIDd) of 5.3 cm.
- The Left Ventricular Hypertrophy (LVH) is normal, and the LV wall thickness is also normal with an Interventricular Septal thickness at end-diastole (IVSd) of 0.6 cm and a Left Ventricular Posterior Wall thickness at end-diastole (LVPWd) of 0.7 cm.
- The systolic function is normal with an Ejection Fraction (EF) of 54% as measured by Global EF - Simpsons, and a visual EF of 55-60% 2.
- The Mass Index is 61 g/m², which is within the normal range.
Diastolic Function Analysis
- The diastolic function is normal with an E/A ratio of 1.2, a Deceleration Time (DT) of 209 ms, an E' Septal of 13.2 cm/s, and an E' Lateral of 18.8 cm/s.
- The E/E' ratio is medial 9.2 and lateral 6.5, which are within normal limits.
- According to a study published in 2022, the assessment of diastolic function by echocardiography may be indeterminate, and left atrial function analysis may contribute to left ventricle filling evaluation in patients with indeterminate diastolic function 2.
- Another study published in 2019 discussed the pathophysiology and echocardiographic diagnosis of left ventricular diastolic dysfunction, highlighting the importance of echocardiography in evaluating diastolic function 3.
Comparison with Other Studies
- A study published in 2008 discussed the challenges of evaluating diastolic function in patients with atrial fibrillation, which is not relevant to this patient's case since they are in sinus rhythm 4.
- A study published in 2001 examined the relationship between left ventricular hypertrophy and sinus variability in arterial hypertension, but this is not directly relevant to the patient's current condition 5.
- A study published in 2023 found that a hyperdynamic heart, defined as a left ventricular ejection fraction above the normal range, is not a normally functioning heart and is associated with increased prevalence of diastolic dysfunction and reduced survival 6. However, this patient's EF is within the normal range.