From the Guidelines
The normal TTE 2D linear ranges for LV dimensions include an LV end-diastolic diameter (LVEDD) of up to 60 mm for men and up to 55 mm for women, and an LV end-systolic diameter (LVESD) of up to 49 mm for men and up to 38 mm for women, as indicated by the most recent evidence 1.
Key Points to Consider
- These measurements are typically obtained from the parasternal long-axis view at the level of the mitral valve leaflet tips using M-mode or 2D imaging.
- The interventricular septal thickness and posterior wall thickness should normally measure between 0.6-1.0 cm, although specific values are not provided in the most recent evidence 1.
- It's worth noting that these values should be indexed to body surface area (BSA) for more accurate interpretation, especially in very small or large individuals, with reported upper limits of LVEDD indexed for body surface area being 35.3 mm/m2 for men and 40.8 mm/m2 for women 1.
- The LV dimensions help determine ejection fraction and are crucial parameters in echocardiographic evaluation of cardiac function and structure.
Clinical Implications
- Measurements above these ranges potentially indicate LV dilation, which may occur in conditions such as heart failure, valvular heart disease, or cardiomyopathies.
- Athletes with severe AR and LVEDD exceeding these values have a high likelihood that severe AR is contributing to the LV dilation and should be evaluated carefully for decreasing exercise tolerance and absence of ventricular augmentation with exercise 1.
- The evidence from 1 provides additional information on left ventricular mass (LVM) and its indexing, but the most relevant and recent information for LV dimensions is found in 1.
From the Research
Normal TTE 2D Linear Ranges for LV Dimensions
- The normal ranges for left ventricular (LV) dimensions using transthoracic echocardiography (TTE) are not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, study 2 mentions that a group with dilated LV cavity had LV internal dimensions in end-diastole ≥ 52 mm, implying that dimensions below this value may be considered normal.
- Study 4 discusses the dilated phase of hypertrophic cardiomyopathy, where patients had increased LV dimensions, but does not provide specific normal ranges.
- Studies 3, 5, and 6 focus on cardiomyopathy overview, genomic context, and current knowledge of cardiomyopathies, respectively, but do not provide normal TTE 2D linear ranges for LV dimensions.
- Therefore, based on the available information, it can be inferred that LV internal dimensions in end-diastole < 52 mm may be considered normal, but this value is not explicitly stated as a normal range in the provided studies 2.