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Echocardiographic examinations

—Echocardiographic examinations

Transthoracic examination
TEE - views
Stress echocardiography
Contrast echocardiography
Cardiac asynchrony
Strain Imaging
3D | 4D echo
Indications for echocardiography
Training in echocardiography

—Cardiac function and PA pressure

—Examples of pathological

Cardiac asynchrony (dyssynchrony)

Guidelines and Standards
Echocardiography for Cardiac Resynchronization Therapy, 2008

The different electromechanical delays are measured from QRS start to contraction start,but some times they will be measured in a time-to-peak manner (QRS to maximal velocity), in cases of difficult TDI profiles.

Assessment of RV and LV delays: (using TDI, RV-free wall, LV septal basal, LV lateral basal, LV posterior basal)

Intraventricular asynchrony: LVsep - LVlat or LVsept - LVpost > 55 ms
Interventricular asynchrony: RVfw - LVsep > 70 ms or RVfw - LVlat > 55ms
Summ of asynchrony: LVas + RVas > 100 ms

Assessment of PET: (pre-ejection time, PW-Doppler, RVOT and LVOT)

Intraventricular asynchrony: LVpet > 140 ms
Interventricular asynchrony: RVpet - LVpet > 40 ms

CRT optimization:

Definite echocardiographic parameters for CRT optimization are still not available. VTI assessment at
the level of the LVOT, right underneath the aortic valve e.g., can give hints to acute changes in left
ventricular function, that may happen during manipulations in AV- and/or LV-RV-Delays and help in the
decision to optimal CRT setting.


© Derliz Mereles


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