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Echo 530

  1. What is systolic function affected by?
    • Preload (LVED pressure)
    • Afterload (Resistance heart must pump against)(Force ventricles face when contracting in systole)
    • Intrinsic Ventricular Contractility (intensity myocardium in active state)
    • Heart Rate
  2. How do you calculate Fractional Shortening and what is the normal range?

    What kind of a measurement is it?
    LVEDd - LVEDs / LVEDd = 20-42%

    dimensional
  3. How do you calculate Ejection Fraction?

    What is the normal range?

    What type of measurement is it?
    LVEDd3 - LVEDs3 / LVEDd3 = 60-85%

    Volumetric measurement
  4. When using Simpson's to evaluate systolic function, what are you really calculating?

    What measurements do you use for Simpson's?
    Ejection fraction

    • A4 Length & Diameter
    • A2 Diameter
  5. Where would you measure for Circumferential Fiber Shortening?

    vcf = mean circumferences / second. What is the formula?
    M-Mode AO valve (LVET)

    vcf = LVEDd - LVEDs / (LVEDd)(LVET)
  6. CO = ?
    CO =(d2)(0.785)(TVI)(HR) / 1000 = L/min

    • CSA= d2 0.785
    • SV = (CSA)(TVI)
  7. TVI = Time Velocity Integral = ?
    Stroke distance in cm
  8. How do you calculate cardiac index?
    CO / BSA
  9. What is the normal CO?
    4-8L/min
  10. EPSS means?
    Measured in what mode?
    Normal measurement is?
    • E Point Septal Separation
    • M-mode
    • 2-7mm

    (AO & LA appear flat when decreased CO)
  11. LV Mass = ?
    (muscle volume)(density) = 1.04g/ml
  12. Wall Stress is directly related to ventricular systolic pressure & _ _ _ _ _ _.
    Wall Stress is indirectly related to wall _ _ _ _ _ _ _ _ _?
    • radius
    • thickness
  13. Wall Stress =
    WS = Force exerted on object / CSA

    RWT=2PWT / LVID
  14. Wall STRAIN is the _ _ _ _ _ applied to solid object causing deformation OR applied to liquid object causing flow strain.

    What modality would we use to assess this?
    • Force
    • Tissue Doppler
  15. Change P / Change T (time interval between 2 arbitrary points)
    What do we use this to assess?
    What jet do we use to measure this?
    What time integral do we use to assess this?
    What is a normal measurement?
    • Time it takes to generate 32mmHg
    • MR
    • MR of 1-3m/s = ?change T
    • 0.027 sec (27ms)
  16. What is the doppler derived index of myocardial performance?
    Myocardial Index
  17. What is the continuity equation for:
    MVA
    AVA
    ERO
    2pi r2(LVOTvel) / MV vel OR AO vel

    vs aliasing vel / MR vel
  18. To measure global ventricular function we use IMP. What does IMP stand for?
    Index Myocardial Performance
  19. IMP = ?

    What is a normal IMP=?
    A-B / B

    • A=Holosystolic
    • B=Systolic ejection time

    IMP=<0.4
  20. Diastolic dysfunction reflects ventricular _________________, not disease specifically
    physiology
  21. Define: Diastole
    Interval of AV closure to MV closure
  22. What does the E on MV waveform represent?
    • Early rapid filling (Active)
    • -early diastole
    • -rate of myocardium relaxation & elastic recoil (suction)
  23. What does the A represent on MV waveform?
    • Passive Force
    • late diastole
    • chamber compliance & stiffness
  24. What are 3 basic causes of diastolic dysfunction?
    • 1. Diseases affecting myocardium
    • 2. Extrinsic - Pericardial disease
    • 3. CAD (dd with systolic dysfunction)
  25. What comes secondary to diseases affecting the myocardium?
    • LVH d/t HTN
    • Hypertrophic CMO
    • Restrictive CMO
    • Ischemic Disease
  26. Name the diastolic parameters. (5)
    • Normal
    • Abnormal Relaxation
    • Pseudonormalization
    • Restrictive filling (reversible)
    • Restrictive filling (irreversible)
  27. What is the formula for ventricular compliance?

    Stiffness?
    Compliance = change volume / change pressure

    Stiffness = change pressure / change volume
  28. What is an advantage of using tissue doppler?
    E velocities are relatively unaffected by preload
  29. Normal E/A Ratio?
    Relax abn?
    Restrictive R ?
    • >1
    • <1

    >2
  30. Normal IVRT?
    relax abn IVRT?
    Restrictive R ?
    • 70
    • >110

    <60
  31. Normal decel time?
    abnormal relax ?
    Restrictive R?
    • 200 ms
    • >240
    • <150
  32. normal E wave?
    abnorm relax?
    Restrictive R?
    • .85 m/s
    • < .5 m/s
    • >1.2 m/s
  33. Normal A wave?
    abnormal relax?
    Restrictive R?
    • .55 m/s
    • <.8 m/s
    • <.3 m/s
  34. Restrictive MV "A" wave duration is ____________________ PV "a" duration time
    less than
  35. What can the valsalve manouver do when assessing diastolic dysfunction?
    unmask pseudonormalization
  36. When you line up MV to PV, what letters occur at same time?
    • E to S
    • A to A
  37. MVA= _______/_______
    220/pht
  38. pht=?
    dt (.29)
  39. Normal pht = _______msec
    severe ?
    • 30-60
    • >220msec
  40. MVA normal = __________?
    Severe = ?
    • >2.5cm2
    • <1.0cm2
  41. With a stiff, noncompliant MV would the pht increase/decrease?
    decrease
  42. What is the best quantification of MR?
    doppler
  43. What does vena contracta mean?
    Flow convergence zone (<0.3mm)
  44. Pulmonary Regurgitation
    PAEDP =
    4V2+RAP
  45. WMSI=
    1-
    2
    3
    4
    5
    • normal
    • hypokinetic
    • akinetic
    • dyskinetic
    • aneurismal
  46. dP/dT = 32/dT

    dT=
    time period between 1 & 3m/s
Author
lstaal1
ID
22338
Card Set
Echo 530
Description
Systolic & Diastolic Function
Updated

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