Echo Pocket 2014

8/9/2019 Echo Pocket 2014

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ECHOCARDIOGRAPHY Guidelines for Valve and Chamber Quantifcation

In partnership with


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Explanatory note & references These guidelines have been developed by theEducation Committee of the British Society ofEchocardiography. They have been adapted fromthe international recommendations and guidelinesreferenced below. Where there are differencesbetween published values, or there is a lack of clearevidence, recommended values have been developedon the basis of consensus opinion.

It is vital that echocardiographic measurements

are made using standard, correct techniques andthat all values are reported and interpreted inclinical context.

Valve Quantication

Recommendations for the echocardiographicassessment of native valvular regurgitation: anexecutive summary from the European Association ofCardiovascular Imaging.Lancelotti et al EHJ-CI 2013; 14:611-644

Guidelines on the management of valvular heartdisease (version 2012). The Joint Task Force onthe Management of Valvular Heart Disease of theEuropean Society of Cardiology (ESC) and the EuropeanAssociation for Cardio-Thoracic Surgery(EACTS).Vahanian et al EHJ 2012; 33:2451-2496

Aortic DimensionsAdapted from: Two-dimensional echocardiographic aortic root

dimensions in normal children and adults. Roman MJet al. Am J Cardiol 1989;64 :50712

Echocardiography in aortic diseases:EAE recommendations for clinical practiceEvangelista et al EJE 2010; 11:645-658

Valve Quantication


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Aortic stenosis

Mild Moderate Severe

4.0

40

1.5-2.0 1.0-1.4


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Aortic regurgitation

Valve Quantication


0.6

500


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Aortic dimensions

Z score (BSA indexed): Dilated - >2.1cm 2 /m 2

A o r t

i c s i n u s e s

d i a m e t e r ( c m

)

4.2

3.8

3.4

3.0

2.6

2.21.6 2.0 2.4

Age 20-39 yr

N o r m

a l

D i l a t

e d

Body Surface Area (m 2)

4.4

4.0

3.6

3.2

2.8

2.41.6 2.0 2.4

Age 40 yr

N o r m

a l

D i l a t e

d

A o r t

i c s i n u s e s

d i a m e t e r ( c m

)

Body Surface Area (m 2)

Valve Quantication


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Mitral stenosis


71-139 140-219 220

10

1.6-2.0 1.0-1.5


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Mitral regurgitation (Primary Organic)



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Tricuspid regurgitation


Not dened 0.7

40

45 Soft/ Dense/ Dense/ parabolic variable triangular early

peaking

Normal Normal/dilated Usually dilated

Systolic Systolic Systolic dominance blunting reversal

VC width (cm)

EROA (mm2)

Regurgitant volume (mL)CW jet density/contour

RA/RV/IVC size

Hepatic vein ow

Valve Quantication


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Tricuspid stenosis

Severe

5

>60


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Pulmonary regurgitation

Jet width % of RVOT width

Pressure half-time

Doppler PR index(duration relative to diastolic cycle)

CF Doppler origin of PR jet.

Doppler timing of PR

Valve Quantication

Severe

>65%


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Chamber Quantication

Explanatory note & references These guidelines have been developed by theEducation Committee of the British Society ofEchocardiography. They have been adapted fromthe international recommendations and guidelinesreferenced below. Where there are differencesbetween published values, or there is a lack of clearevidence, recommended values have been developedon the basis of consensus opinion.

It is vital that echocardiographic measurements

are made using standard, correct techniques andthat all values are reported and interpreted inclinical context.


Adapted from:Recommendations for Chamber Quantication: AReport from the American Society of EchocardiographysGuidelines and Standards Committee and the ChamberQuantication Writing Group, Developed in Conjunctionwith the European Association of Echocardiography, aBranch of the European Society of Cardiology.Lang RM et al. J Am Soc Echocardiogr 2005;18 :14401463

Right Ventricular FunctionAdapted from:Guidelines for the Echocardiographic Assessmentof the Right Heart in Adults: A Report from the ASEEndorsed by the EAE, and the CSE. Rudski, LG, et al. JAm Soc Echocardiogr 2010; 23 :685-713.


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L e f t v e n t r i c u

l a r s i z e , m a s s

& f u n c

t i o n

C h a m

b e r

Q u a n

t i c a

t i o n

N o r m

a l

M i l d

M o d

e r a

t e

S e v e r e

L V w a

l l t h i c k n e s s

I V S d / P W d ( c m )

L V d i m e n s i o n , w o m e n

L V I D d ( c m )

L V I D d / B S A ( c m / m 2 )

L V d i m e n s i o n , m e n

L V I D d ( c m )

L V I D d / B S A ( c m / m 2 )

L V v o

l u m e , w o m e n

L V d i a s t o l i c v o l u m e ( m L )

L V s y s t o l i c v o l u m

e ( m L )

L V v o

l u m e , m e n

L V d i a s t o l i c v o l u m e ( m L )


e ( m L )

L V v o

l u m e

i n d e x

L V d i a s t o

l i c v o

l u m e

/ B S A ( m L / m

2 )


e / B S A ( m L / m

2 )

L V f u n c t

i o n

F r a c t i o n a l s h o r t e n i n g ( % )

E j e c t i o n f r a c t i o n

( % )

L V m a s s

, w o m e n

2 D

L V m a s s ( g )

L V m a s s / B S A ( g / m 2 )

L V m a s s

, m e n 2

D

L V m a s s ( g )

L V m a s s / B S A ( g / m 2 )

0 . 6 - 1

. 2

1 . 3 - 1 . 5

1 . 6 - 1 . 9

2 . 0

3 . 9 - 5

. 3

5 . 4 - 5 . 7

5 . 8 - 6 . 1

6 . 2

2 . 4 - 3

. 2

3 . 3 - 3 . 4

3 . 5 - 3 . 7

3 . 8

4 . 2 - 5

. 9

6 . 0 - 6 . 3

6 . 4 - 6 . 8

6 . 9

2 . 2 - 3

. 1

3 . 2 - 3 . 4

3 . 5 - 3 . 6

3 . 7

5 6 - 1

0 4

1 0 5 - 1 1 7

1 1 8 - 1

3 0

1 3 1

1 9 - 4 9

5 0 - 5

9

6 0 - 6

9

7 0

6 7 - 1

5 5

1 5 6 - 1 7 8

1 7 9 - 2

0 1

2 0 2

2 2 - 5 8

5 9 - 7

0

7 1 - 8

2

8 3

3 5 - 7 5

7 6 - 8

6

8 7 - 9

6

9 7

1 2 - 3 0

3 1 - 3

6

3 7 - 4

2

4 3

2 5 - 4 3

2 0 - 2

4

1 5 - 1

9

< 1 5

5 5

4 5 - 5

4

3 6 - 4

4

3 5

6 6 - 1

5 0

1 5 1 - 1 7 1

1 7 2 - 1

9 3

> 1 9 3

4 4 - 8 8

8 9 - 1

0 0

1 0 1 - 1

1 2

> 1 1 2

9 6 - 2

0 0

2 0 1 - 2 2 7

2 2 8 - 2

5 4

> 2 5 4

5 0 - 1

0 2

1 0 3 - 1 1 6

1 1 7 - 1

3 0

> 1 3 0

E F b y B i p l a n e S i m p s o n s m e t h o d *

* P l e a s e s e e e x p l a n a t o r y n o t e


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Left ventricular diastolic function


E/A, DT, s/d, e, LA volume

E/A, A 1-2DT 130-230

E/A >2**DT 1 E/e 1 E/e usually 8#

e reduced

LA

s/d 13

LA

s/d


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Left atrial size

LA size, womenLA diameter (cm) LA volume (mL)

LA size, menLA diameter (cm) LA volume (mL)

LA size, indexLA diameter (cm/m 2) LA volume (mL/m 2)

Normal Mild Moderate Severe

2.7-3.8 3.9-4.2 4.3-4.6 4.7 22-52 53-62 63-72 73

3.0-4.0 4.1-4.6 4.7-5.2 5.3 18-58 59-68 69-78 79

1.5-2.3 2.4-2.6 2.7-2.9 3.0 16-28 29-33 34-39 40



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Right ventricular size & function

RV dimensions (apical 4 chamber)Basal RV diameter (RVD1) (cm) Mid RV diameter (RVD2) (cm) RV wall thickness (mm)

RVOT diameters (parasternal SAX)RVOT at AV level (RVOT1) (cm)

RVOT at PV annulus (RVOT2) (cm)PA diameter (parasternal SAX)Main PA (PA1) (cm)

RV areaRV diastolic area (cm 2)

RV systolic area (cm 2)

RV functionFractional area change (%) TAPSE (mm)

Abnormal

>4.2>3.5

>5.0

>3.5

>2.7

>2.2

>25

>14


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British Society of Echocardiography Education CommitteeRichard Steeds (Chair), Gill Wharton (Lead Author), Katherine Collins, Jane Allen,Jane Graham, Richard Jones, Bushra Rana, Liam Ring, Navroz Masani


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Documents

Echo Pocket 2014