From the Guidelines
The patient's echocardiogram results indicate normal cardiac structure and function, with no evidence of heart failure or structural heart disease, and therefore, no specific cardiac interventions are needed at this time. The left ventricle has a normal chamber size (LVIDd 5.3 cm), normal wall thickness without hypertrophy (IVSd 0.6 cm, LVPWd 0.7 cm), and normal systolic function with an ejection fraction of 54-60% 1. Diastolic function is also normal with an E/A ratio of 1.2 and appropriate tissue Doppler measurements (E/E' medial 9.2, E/E' lateral 6.5). The left atrium is normal in size with a very low indexed volume of 8.3 ml/m². The right ventricle shows normal wall thickness, chamber size (RVID mid 2.5 cm), and systolic function (TAPSE 2.6 cm).
According to the ACC/AHA versus ESC guidelines on heart failure, the patient's LVEF of 54-60% falls into the normal range, and there is no evidence of heart failure with reduced ejection fraction (HFrEF) or heart failure with preserved ejection fraction (HFpEF) 1. The guidelines emphasize the importance of LVEF in classification, and the patient's LVEF is above the threshold for HFrEF.
Key points to note from the echocardiogram results include:
- Normal left ventricular chamber size and wall thickness
- Normal systolic and diastolic function
- Normal left atrial size and volume
- Normal right ventricular wall thickness, chamber size, and systolic function
- No evidence of structural heart disease or chamber enlargement.
Overall, the patient's cardiac structure and function are within normal limits, and no specific cardiac interventions are needed based on these findings, as all parameters fall within normal ranges 1.
From the Research
Left Ventricle Assessment
- The left ventricle chamber size is reported as normal with a Left Ventricular Internal Dimension at end-diastole (LVIDd) of 5.3 cm.
- Left Ventricular Hypertrophy (LVH) is also reported as 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 2.
- Systolic function is normal, with an visually estimated Ejection Fraction (EF) of 55-60% and a Mass Index of 61 g/m².
- Global EF, as measured by Simpson's method, is 54%, which is within the normal range according to recent studies 2.
Diastolic Function Assessment
- Diastolic function is reported as normal, with an E/A ratio of 1.2 and a Deceleration Time (DT) of 209 ms.
- Tissue Doppler imaging shows normal E' septal and lateral velocities, with values of 13.2 cm/s and 18.8 cm/s, respectively.
- The E/E' ratio, a measure of left ventricular filling pressure, is also within normal limits, with a medial E/E' of 9.2 and a lateral E/E' of 6.5 3, 4.
Left Atrium Assessment
- The left atrium size is reported as normal, with a trace indexed volume and a volume index of 8.3 ml/m².
- This is consistent with recent studies that provide updated normal reference ranges for echocardiographic measures, including left atrial volume index 2.
Right Ventricle Assessment
- The right ventricle wall thickness is reported as normal.
- The chamber size is also normal, with a Right Ventricular Internal Dimension at end-diastole (RVID) of 2.5 cm.
- Systolic function is normal, with a Tricuspid Annular Plane Systolic Excursion (TAPSE) of 2.6 cm.
- These findings are consistent with recent studies that provide updated normal reference ranges for echocardiographic measures, including right ventricular dimensions 2.