From the Guidelines
The patient's echocardiogram results indicate a normal cardiac structure and function, with no evidence of heart failure or other cardiac abnormalities that would require intervention or follow-up from a cardiovascular perspective. The left ventricle has a normal chamber size (LVIDd 5.3 cm) with normal wall thickness (IVSd 0.6 cm, LVPWd 0.7 cm) and no left ventricular hypertrophy, which is consistent with the guidelines for heart failure diagnosis and treatment 1. Systolic function is normal with an ejection fraction of 54-60%, which is above the threshold for heart failure with reduced ejection fraction (HFrEF) defined by the ESC criteria as LVEF ≤40% 1. Diastolic function is also normal with an E/A ratio of 1.2, deceleration time of 209 ms, and normal tissue Doppler velocities (E' septal 13.2 cm/s, E' lateral 18.8 cm/s) with normal filling pressures (E/E' medial 9.2, E/E' lateral 6.5). Some key points to note about the patient's results include:
- Normal left atrial size with a very low indexed volume of 8.3 ml/m²
- Normal right ventricle wall thickness, chamber size (RVID mid 2.5 cm), and systolic function (TAPSE 2.6 cm)
- No evidence of left ventricular hypertrophy or other structural abnormalities that would require intervention or follow-up
- Normal systolic and diastolic function, which suggests a low risk of heart failure or other cardiac complications Overall, the patient's echocardiogram results are normal, and there is no evidence of cardiac disease or abnormality that would require intervention or follow-up from a cardiovascular perspective, as supported by the guidelines for heart failure diagnosis and treatment 1.
From the Research
Left Ventricle Assessment
- The left ventricle ejection fraction (LVEF) is 54% as measured by Simpsons, and 55-60% as visually estimated, which is within the normal range 2.
- The left ventricular internal dimension at end-diastole (LVIDd) is 5.3 cm, which is within normal limits 2.
- The left ventricular mass index is 61 g/m², indicating no left ventricular hypertrophy (LVH) 2.
- The E/A ratio is 1.2 and the deceleration time (DT) is 209 ms, suggesting normal diastolic function 3, 4.
- The E/e' ratio is 9.2 for the medial and 6.5 for the lateral, indicating normal diastolic function 5.
Left Atrium Assessment
- The left atrial volume index is 8.3 ml/m², which is within normal limits 2.
Right Ventricle Assessment
- The right ventricular internal dimension at end-diastole (RVID) is 2.5 cm, which is within normal limits 2.
- The tricuspid annular plane systolic excursion (TAPSE) is 2.6 cm, indicating normal right ventricular systolic function 3.
Diagnostic Implications
- The comprehensive assessment of cardiac structure and function, including left and right ventricular function, left atrial size, and valvular function, is essential for the diagnosis and management of heart failure 3.
- The E/e' ratio is a useful marker of risk for cardiovascular events 5.
- Echocardiography plays a central role in the evaluation of heart failure with preserved ejection fraction (HFpEF) 4.