From the Guidelines
The patient's echocardiogram results indicate a normal cardiac structure and function, with no evidence of heart failure or structural heart disease, and therefore, no specific cardiac interventions are needed based on these findings. 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 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 from the echocardiogram results include:
- Normal left ventricular chamber size and wall thickness
- Normal systolic function with an ejection fraction of 54-60%
- Normal diastolic function with normal tissue Doppler velocities and filling pressures
- Normal left atrial size with a very low indexed volume of 8.3 ml/m²
- Normal right ventricular wall thickness, chamber size, and systolic function
The left atrium is normal in size with a very low indexed volume of 8.3 ml/m², and the right ventricle has normal wall thickness, chamber size (RVID mid 2.5 cm), and systolic function (TAPSE 2.6 cm), which further supports the absence of structural heart disease or heart failure. Overall, these findings are consistent with a completely normal cardiac ultrasound, and no specific cardiac interventions are needed based on these findings, as supported by the guidelines for heart failure diagnosis and treatment 1.
From the Research
Left Ventricle Assessment
- The left ventricle chamber size is normal with a LVIDd of 5.3 cm, which is within the normal range 2.
- The left ventricular hypertrophy (LVH) is normal with an IVSd of 0.6 cm and LVPWd of 0.7 cm.
- The systolic function is normal with an ejection fraction (EF) of 55-60% and a mass index of 61 g/m².
- The global EF measured by Simpsons is 54%, which is within the normal range 2.
- The diastolic function is normal with an E/A ratio of 1.2 and a deceleration time (DT) of 209 ms.
- The E' septal and lateral velocities are 13.2 cm/s and 18.8 cm/s, respectively, and the E/E' medial and lateral ratios are 9.2 and 6.5, respectively, indicating normal diastolic function 3.
Left Atrium Assessment
- The left atrium size is normal with a trace indexed volume of 8.3 ml/m², which is within the normal range 2.
Right Ventricle Assessment
- The right ventricle wall thickness is normal.
- The chamber size is normal with an RVID mid of 2.5 cm.
- The systolic function is normal with a TAPSE of 2.6 cm.
Risk Factors for Diastolic Dysfunction
- Diabetes, hypertension, and increasing age are risk factors for diastolic dysfunction, and they can explain a moderate amount of the variance in conventional diastolic parameters such as E' velocities, E/A ratio, and E/e' 3.
- The effect of these risk factors on left atrial volume index and other parameters is less pronounced 3.
- Echocardiography is an essential diagnostic modality for evaluating cardiovascular diseases in patients with diabetes mellitus, and it can detect early changes in ventricular dysfunction before heart failure symptoms develop 4.