Quantitative Assessment and Hemodynamics Outline

Quantitative M Mode

• Quantitative M Mode
  • Measurement Accuracy
    • Sources of Error
• Left Ventricular Volume, Mass, and Geometry
  • M Mode
    • Mass
      • Prolate Ellipsoid Method
    • Volume
    • Relative Wall Thickness (RWT)
    • LV Remodeling States

Quantitative 2D

• Foreshortening
• Left Ventricular Contraction
• Mass
  • Cylinder-Hemiellipsoid Method
• Area
  • Fractional Area Change
  • Fractional Shortening (FS)
  • Circumferential Shortening
• Volume
  • Method of Discs (MOD)
  • Acoustic Quantification
  • SAX/LAX Method
  • Area-Length Method
  • Ejection Fraction

Geometry

• SAX/LAX Ratios
• Ventricular Remodeling
  • Normal
  • Concentric Remodeling
  • Concentric Hypertrophy
  • Hypertrophic Cardiomyopathy
  • Eccentric Hypertrophy
  • Dilated Cardiomyopathy

Quantitative Doppler

• Doppler Echocardiography
  • Velocity Time Integral (VTI)
  • Cross Sectional Area (CSA)
  • Volume
• Assessment of Left Ventricular Systolic Function
  • Ejection Fraction (LVEF)
  • Circumferential Velocity Shortening (Vcf)
  • Mitral Annulus Excursion
• Stress Shortening Relationships
  • Midwall Stress Shortening Analysis
    • Pressure-Volume Analysis

Normal Flow Patterns

• Left Ventricular Outflow Tract (LVOT)
• Left Ventricular Inflow (LVI)
• Pulmonary Vein Doppler (PVD)
• Right Ventricular Outflow Tract (RVOT)
• Right Ventricular Inflow (RVI)
• Hepatic Vein Doppler (HVD)

Stenotic Flow Patterns

• Overview
• High-Velocity Jet
• Vena Contracta
• Distal Flow Disturbance (Turbulence)
• Proximal Flow Pattern
  • Proximal Isovelocity Surface Area (PISA)
• Relationship Between Pressure Gradient and Velocity
  • Bernoulli Equation
  • Modified Bernoulli Equation
  • Simplified Bernoulli Equation
• Pressure Half-Time (PHT) and Deceleration Time (DT)

Regurgitant Flow Patterns

• Regurgitant Jet
• Jet Size
• PISA Formation
• Vena Contracta
• Flow Profile Quality

Pressure Measurements

• Central Venous Pressure (CVP)
• Pulmonary Artery Systolic Pressure (RVSP or PASP)
• Pulmonary Diastolic Pressure (PADP)
• Pulmonary Capillary Wedge Pressure (PCWP)
• Left Atrial Pressure (LAP)
• Left Ventricular End-Diastolic Pressure (LVEDP)
• Stroke Volume and Cardiac Output (SV and CO)

Quantitative Doppler and Hemodynamic Assessment

• Continuity Equation (CE)
• Effective Regurgitant Orifice (ERO or EOA)
• Regurgitant Volume (RV) or Regurgitant Fraction (RF)
• Shunt Fraction (Qp/Qs)
• Contractile Function of the Heart
  • dP/dt
  • Pressure-Area Loops
• Tissue Doppler Imaging (TDI)
• Isovolemic Ventricular Relaxation Time (IVRT)
• Other Calculations
  • Body Surface Area (BSA)
  • Stroke Index (SI), Cardiac Output (CO) and Cardiac Index (CI)