Left Ventricular Systolic Function
| Normal | |
| LV dP/dT | ≥1200 mmHg/sec |
| Fractional Shortening | ≥ 30% |
| VTI of LVOT | 18–22 |
| VTI of MV | 10–13 |
S1 < 3.0 cm/sec and E1 < 3.0 cm/sec – high cardiac mortality predictors
S1 > 7.5 cm/sec (peak myocardial systolic velocity averaged from 6 points around mitral valve annulus) – suggests grossly normal LVEF
M-mode markers of decreased LV systolic function:
- E-Septal separation > 2.5 cm implies EF < 25%;
- Closure drift of the AV at the end systole;
- Flattening of the posterior aorta;
- E-Septal separation > 0.6 cm suggests decreased EF.
Left Ventricular Diastolic Patterns
- Mitral inflow assessed 20° lateral to apex, between the tips of leaflets.
- Pulmonary vein flow assessed 1.5 cm into the RUPV.
- Hepatic vein flow assessed 1–2 cm prox to junction with IVC.
- DT: deceleration time, extrapolated from peak of “E” wave to baseline.
- IVRT: isovolumetric relaxation time (from AV closure to MV opening; parallels DT).
- mA/pa: relative duration of mitral “A” wave to PV “a” wave;
pVs1: atrial relaxation;
pVs2: late flow into the LA in vent systole; (pVs1 & pVs2 are fused in 70%);
pVd: mitral opening (mirrors “E” wave of MV flow, ↓DTof pVd with ↑ LVEDP);
pVa: atrial systole → flow reversal (peak & duration ↑ with ↑ LVEDP).
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