Left ventricle size

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With the measurement of the left ventricle diameter in diastole and in systole, you will be able to determine if the left ventricle is:

-normal size

-dilated: mildly, moderately or severely

-small


The left ventricle diameter is measured in parasternal long axis, at the tip of the mitral leaflets, at the interface blood-internall wall.


Contents

Diastolic diameter: 

Left ventricle end-diastolic diameter: LVED, is the most important. It is measured at end diastole, on the frame after mitral closure. It normally corresponds to the largest cardiac dimension.


LVED measurement.jpg


Systolic diameter:

Left ventricle end-systolic diameter: LVES, is measured at end systole, on the frame preceding mitral valve opening. It corresponds to the smallest cardiac dimension.


LVES measurement.jpg


M-mode measurements:

The LV dimensions can be measured in M-mode. This imaging modality allows the visualization of each structure depending on the time and gives a better image resolution than 2D imaging. However you must be sure that the imaging beam is cutting perpendicularly the long axis of the left ventricle, otherwise you will overestimate the LV size.

LV measurement Mmode.jpg



Normal and abnormal values:
LVED (mm) Normal Mildly dilated Moderately dilated Severely dilated
Men 42-59 60-63 64-68 >69
Women 39-53 54-57 58-61 >62




Left ventricle shortening fraction:


With the left ventricle end-diastolic and end-systolic diameters, you will be able to calculate the shortening fraction. The shortening fraction reflects the left ventricle systolic function, but is valid only if the left ventricle geometry is normal and in the absence of wall motion abnormality.


Formula shortening fraction.jpg

                             

Shortening fraction  %
Normal 25-45
Mild 20-25
Moderate 15-20
Severe <15
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