From the Guidelines
Given the normal Left Ventricular (LV) systolic function, normal Left Ventricular (LV) diastolic filling pressure, and normal Right Ventricular (RV) systolic function, the overall assessment of cardiac function is normal, indicating good heart function with no significant abnormalities in systolic or diastolic function. The evaluation of diastolic properties of the left ventricle, including those related to lusitropy (relaxation) and compliance (stiffness), is based on schema developed for echocardiography, using patterns of mitral inflow and annular velocities, tricuspid regurgitation velocity, left atrial size, and pulmonary vein flow velocities 1.
The normal LV systolic function, as indicated by a normal left ventricular ejection fraction, suggests that the heart is pumping blood effectively 1. The normal LV diastolic filling pressure, as indicated by a normal E/A ratio and peak E velocity, suggests that the left ventricle is filling properly during diastole 1. The normal RV systolic function suggests that the right ventricle is pumping blood effectively into the pulmonary circulation.
Key parameters to assess diastolic function include:
- Mitral inflow pattern, including E/A ratio and peak E velocity
- Mitral annular velocities, including e′ and a′ velocities
- Tricuspid regurgitation velocity
- Left atrial size
- Pulmonary vein flow velocities
According to the 2019 ACC/AHA/ASE key data elements and definitions for transthoracic echocardiography, left ventricular diastolic function is defined as relaxation and filling during the period after aortic valve closure and before aortic valve opening, and is classified as normal, grade 1, grade 2, grade 3, or unknown 1.
In this case, with normal LV systolic function, normal LV diastolic filling pressure, and normal RV systolic function, the overall assessment of cardiac function is normal, and no significant abnormalities in systolic or diastolic function are present. Regular follow-up with a cardiologist would be appropriate to track any progression of cardiac function over time.
From the Research
Cardiac Function Assessment
Given normal Left Ventricular (LV) systolic function, normal Left Ventricular (LV) diastolic filling pressure, and normal Right Ventricular (RV) systolic function, the overall assessment of cardiac function can be evaluated based on the following points:
- Normal LV systolic function indicates that the left ventricle is able to contract and pump blood effectively 2, 3.
- Normal LV diastolic filling pressure suggests that the left ventricle is able to relax and fill with blood properly 4, 5.
- Normal RV systolic function indicates that the right ventricle is able to contract and pump blood effectively.
Key Findings
Some key findings related to cardiac function include:
- Concentric left ventricular hypertrophy can bring deterioration of systolic longitudinal, circumferential, and radial myocardial deformation in hypertensive patients with preserved left ventricular pump function 5.
- Mitral valve regurgitation is a powerful factor of left ventricular hypertrophy, and can alter cardiac dimensions and function parameters 3.
- Eccentric hypertrophy denotes a distinct subset of heart failure with preserved ejection fraction that is pathophysiologically similar to heart failure with reduced ejection fraction 4.
Factors Influencing Cardiac Function
Several factors can influence cardiac function, including:
- Left ventricular hypertrophy, which can be classified as concentric or eccentric based on left ventricular relative wall thickness 2.
- Mitral valve regurgitation, which can cause volume overload, dilatation, and enlargement of the left ventricle and atrium 3.
- Antihypertensive therapy with beta blockers, which can induce regression of left ventricular hypertrophy in hypertensive subjects 6.