Hello,
I was taught to do the diastolic LV measurements at the end of diastoli on the m-mode; the widest LV chamber right before systoli.
I have also heard that the measurements can be done at the beginning of the QRS complex when using the ECG tracing. My question is, when they don’t line up (and they rarely do on my machine/patients) which one is more accurate?
I’m hoping this is a question that can be answered without a picture. If not, I’ll search my files to find an example.
Thanks
Karen
Hello,
I was taught to do the diastolic LV measurements at the end of diastoli on the m-mode; the widest LV chamber right before systoli.
I have also heard that the measurements can be done at the beginning of the QRS complex when using the ECG tracing. My question is, when they don’t line up (and they rarely do on my machine/patients) which one is more accurate?
I’m hoping this is a question that can be answered without a picture. If not, I’ll search my files to find an example.
Thanks
Karen
Comments
Hi Karen!
End-distolic
Hi Karen!
End-distolic measurements should generally be done at the beginning of the QRS-complex. By definition this is the most accurate measurement. Systolic measurements should be done either at the maximal downward movement of the septum or when septum and free wall are closest to each other (no consensus, I think most cardiologists use the first downward movement of the septum). What I do is: If they ´don´t line up in an M-Mode obtained from a 4 chamber view I try the short axis view or vice versa. Btw thatý one of multiple reasons why fractional shortening is not an accurate tool for determining systolic function. If I´m not sure about systolic function e.g. because of asynchronous movements of septum and free wall, use EF obtained from Simpson´s method.
best Regards!
Peter
Hi Karen!
End-distolic
Hi Karen!
End-distolic measurements should generally be done at the beginning of the QRS-complex. By definition this is the most accurate measurement. Systolic measurements should be done either at the maximal downward movement of the septum or when septum and free wall are closest to each other (no consensus, I think most cardiologists use the first downward movement of the septum). What I do is: If they ´don´t line up in an M-Mode obtained from a 4 chamber view I try the short axis view or vice versa. Btw thatý one of multiple reasons why fractional shortening is not an accurate tool for determining systolic function. If I´m not sure about systolic function e.g. because of asynchronous movements of septum and free wall, use EF obtained from Simpson´s method.
best Regards!
Peter
If you don´t have an ECG
If you don´t have an ECG available then you should take enddistolic measurements at the maximal diameter. In clinical cases this will not make a significant difference. But if you´re doing a breeding examination you should always use an ECG in order to time your measurements poperly (M-Mode, PEP/LVET, LA/AO etc)
Hope I could help
Peter
If you don´t have an ECG
If you don´t have an ECG available then you should take enddistolic measurements at the maximal diameter. In clinical cases this will not make a significant difference. But if you´re doing a breeding examination you should always use an ECG in order to time your measurements poperly (M-Mode, PEP/LVET, LA/AO etc)
Hope I could help
Peter
Thanks Peter. Very helpful!
Thanks Peter. Very helpful!
Thanks Peter. Very helpful!
Thanks Peter. Very helpful!