From the Guidelines
The patient's echocardiogram results indicate a healthy heart with normal cardiac structure and function, and therefore, no specific interventions are needed beyond regular age-appropriate cardiovascular health maintenance. 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 velocities (E' septal 13.2 cm/s, E' lateral 18.8 cm/s). The left atrium is normal in size with a trace indexed volume of 8.3 ml/m². The right ventricle demonstrates normal wall thickness, chamber size (RVID mid 2.5 cm), and systolic function (TAPSE 2.6 cm).
Key Findings:
- Normal left ventricular chamber size and wall thickness
- Normal systolic and diastolic function
- Normal left atrial size and right ventricular parameters
- No evidence of structural abnormalities or chamber enlargement
Recommendations:
- Regular blood pressure monitoring
- Healthy diet
- Regular exercise
- Avoidance of tobacco products
- Regular age-appropriate cardiovascular health check-ups, as the current guidelines suggest that clinical trials have demonstrated a mortality benefit in patients with heart failure with reduced ejection fraction (HFrEF) 1. However, since this patient's ejection fraction is within the normal range (54-60%), these specific guidelines do not apply.
From the Research
Left Ventricle Evaluation
- The left ventricle chamber size is normal with a LVIDd of 5.3 cm 2.
- The left ventricle mass index is 61 g/m², which is within normal limits 2.
- The systolic function is normal with an EF of 55-60% and a global EF of 54% using Simpson's method 2.
- The diastolic function is normal with an E/A ratio of 1.2 and a DT of 209 ms 3, 4.
- The E' septal and lateral velocities are 13.2 cm/s and 18.8 cm/s, respectively, which are within normal limits 3.
- The E/E' medial and lateral ratios are 9.2 and 6.5, respectively, which are within normal limits 3.
Left Atrium Evaluation
- The left atrium size is normal with a volume index of 8.3 ml/m² 2.
- The left atrium volume index is within normal limits, with upper normal limits ranging from 44 ml/m² to 53 ml/m² according to sex-specific age groups 2.
Right Ventricle Evaluation
- The right ventricle wall thickness is normal 2.
- The right ventricle chamber size is normal with an RVID mid of 2.5 cm 2.
- The systolic function is normal with a TAPSE of 2.6 cm 2.
Diagnostic Implications
- The comprehensive echocardiographic evaluation can help differentiate among heart failure with preserved ejection fraction patients, hypertensive patients, and healthy control subjects 5.
- The echocardiographic parameters, such as global longitudinal strain and extracellular volume, can be used to identify patients with prognostically significant functional limitation 5.
- The presence of diabetes, hypertension, sex, and increasing age can explain a moderate amount of the variance in conventional diastolic parameters related to myocardial tissue velocities and E/A ratio in a healthy outpatient population 3.