lv echocardiogram | ejection fraction vs fractional shortening

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The left ventricle (LV) is the heart's primary pumping chamber, responsible for propelling oxygenated blood to the body. Accurate assessment of its function is crucial in diagnosing and managing a wide range of cardiovascular diseases. Left ventricular (LV) echocardiography is a non-invasive, readily available, and highly valuable imaging technique providing detailed information about LV structure and function. This article will delve into the various aspects of LV echocardiography, focusing on the assessment of LV function using different echocardiographic modalities, including M-mode and 2-dimensional (2-D) echocardiography, and clarifying the concepts of ejection fraction (EF) and fractional shortening (FS).

Echocardiogram LV Function:

Echocardiography, employing ultrasound waves, generates real-time images of the heart's structure and motion. Assessment of LV function involves evaluating several key parameters, providing a comprehensive picture of the heart's pumping ability. These parameters, derived from both M-mode and 2-D echocardiography, include:

* Ejection Fraction (EF): This is the most commonly used index of LV systolic function. EF represents the percentage of blood ejected from the LV with each contraction. A normal EF generally ranges from 55% to 70%, although this can vary slightly based on age and other factors. Reduced EF indicates impaired systolic function, often seen in conditions like heart failure.

* Fractional Shortening (FS): This parameter reflects the extent of LV shortening during systole. It is calculated as the difference between the end-diastolic dimension (EDD) and end-systolic dimension (ESD), divided by the EDD. FS provides a complementary assessment of systolic function, especially useful when evaluating regional wall motion abnormalities.

* Stroke Volume (SV): This represents the volume of blood ejected from the LV with each heartbeat. It's calculated using various echocardiographic measurements and is influenced by both preload (end-diastolic volume) and contractility.

* Cardiac Output (CO): This is the total volume of blood pumped by the LV per minute. It's a product of stroke volume and heart rate and reflects the overall effectiveness of the heart's pumping action.

* Wall Thickness: Echocardiography allows measurement of LV wall thickness, providing insights into hypertrophy (thickening) or thinning of the myocardial wall. These changes can indicate various pathological conditions, such as hypertension or cardiomyopathy.

* Regional Wall Motion: 2-D echocardiography enables visualization of the LV wall motion throughout the cardiac cycle. Assessment of regional wall motion helps identify areas of impaired contraction, often indicative of myocardial infarction or other localized myocardial disease.

How to Assess LV Function:

Assessment of LV function using echocardiography involves a systematic approach, typically incorporating both M-mode and 2-D techniques. While M-mode provides linear measurements, 2-D echocardiography offers a comprehensive visualization of the LV chamber and its movement.

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