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Echocardiography: Guidelines for Chamber Quantification

British Society of Echocardiography Education Committee


Navroz Masani (Chair), Gill Wharton (Lead Author), Jane Allen, John Chambers, Jane Graham, Richard Jones, Bushra Rana, Richard Steeds

Left ventricular size, mass & function


LV wall thickness IVSd / PWd (cm) LV dimension, women LVIDd (cm) LVIDd / BSA (cm/m2) LV dimension, men LVIDd (cm) LVIDd / BSA (cm/m2) LV volume, women LV diastolic volume (ml) LV systolic volume (ml) LV volume, men LV diastolic volume (ml) LV systolic volume (ml) LV volume index LV diastolic volume/BSA (ml/m2) LV systolic volume/BSA (ml/m2) Normal Mild Moderate 1.61.9 5.86.1 3.53.7 6.46.8 3.53.6 118130 6069 179201 7182 8796 3742 1519 3644 172182 101112 228254 117130 Severe 2.0 6.2 3.8 6.9 3.7 131 70 202 83 97 43 <15 35 >182 >112 >254 >130 0.61.2 1.31.5 3.95.3 2.43.2 5.45.7 3.33.4 6.06.3 3.23.4 105117 5059 156178 5970 7686 3136 2024 4554 151171 89100 201227 103116

Left atrial size


LA size, women LA diameter (cm) LA volume (ml) LA size, men LA diameter (cm) LA volume (ml) LA size, index LA diameter (cm/m2) LA volume (ml/m2) Normal Mild Moderate Severe

4.25.9 2.23.1 56104 1949 67155 2258

2.73.8 3.94.2 2252 5362 3.04.0 4.14.6 1858 59-68 1.52.3 2.42.6 1628 2933

4.34.6 6372

4.7 73 5.3 79 3.0 40

4.75.2 6978

2.72.9 3439

3575 1230 LV function Fractional shortening (%) 2543 55 Ejection fraction (%) EF by Biplane Simpsons method* LV mass, women 66150 LV mass (g) 2 4488 LV mass / BSA (g/cm ) LV mass, men LV mass (g) LV mass / BSA (g/cm2)
*Please see explanatory note

Right ventricular size & function


Normal Mild Moderate Severe RV dimensions (apical 4 chamber) Basal RV diameter (RVD1) (cm) 2.02.8 2.93.3 2.73.3 3.43.7 Mid RV diameter (RVD2) (cm) Base to apex length (RVD3) (cm) 7.17.9 8.08.5 RVOT diameters (parasternal SAX) RVOT at AV level (RVOT1) (cm) 2.52.9 3.03.2 RVOT at PV annulus (RVOT2) (cm) 1.72.3 2.42.7 PA diameter (parasternal SAX) Main PA (PA1) (cm) 1.52.1 2.22.5 RV area 2 RV diastolic area (cm ) 1128 2932 2 RV systolic area (cm ) 7.516 1719 RV function Fractional area change (%) 3260 2531 1620 1115 TAPSE

3.43.8 3.84.1 8.69.1

3.9 4.2 9.2 3.6 3.2 3.0 38 23 17 5

96200 50102

3.33.5 2.83.1

2.62.9

3337 2022

Left ventricular diastolic function


Normal Mild Relaxation Moderate Relaxation Compliance LVEDP Pseudo-Normal Severe Relaxation Compliance LVEDP Restrictive filling

1824 610

Abnormal relaxation LV inflow Doppler

Right atrial pressure


IVC size (cm) Respiratory/sniff variation Other RA size Hepatic vein size 05mmHg 510 1015 1520 >20

E/A ratio IVRT (ms) DT (ms) Pulmonary venous Doppler

12 50100 150200

<1 >100 >200

12 50100 150200

>2 <50 <150

<1.5 1.52.5 1.52.5 collapse >50% <50% normal normal

>2.5 >2.5 <50% No change

PVS /PVD PVa (m/s) adurAdur (ms) Mitral annular tissue Doppler

PVS > PVD <0.35 <20

PVS > PVD <0.35 <20

PVS < PVD 0.35 20

PVS << PVD 0.35 20

Explanatory note & references


These guidelines have been developed by the Education Committee of the British Society of Echocardiography. They have been adapted from the international recommendations and guidelines referenced below. Where there are differences between published values, or there is a lack of clear evidence, recommended values have been developed on the basis of consensus opinion. It is vital that echocardiographic measurements are made using standard, correct techniques and that all values are reported and interpreted in clinical context.
Chamber Quantification Adapted from: Recommendations for Chamber Quantification: A Report from the American Society of Echocardiographys Guidelines and Standards Committee and the Chamber Quantification Writing Group, Developed in Conjunction with the European Association of Echocardiography, a Branch of the European Society of Cardiology. Lang RM et al. J Am Soc Echocardiogr 2005; 18:14401463 Right Ventricular Function Adapted from: Assessment of right ventricular function using twodimensional echocardiography Kaul S et al. Am. Heart J 1984;107:52631 Diastolic Function Adapted from: Canadian consensus recommendations for the measurement and reporting of diastolic dysfunction by echocardiography: from the Investigators of Consensus on Diastolic Dysfunction by Echocardiography. Rakowski H et al. J Am Soc Echocardiogr 1996;9:736-760 Optimal Noninvasive Assessment of Left Ventricular Filling Pressures. A Comparison of Tissue Doppler Echocardiography and B-Type Natriuretic Peptide in Patients With Pulmonary Artery Catheters. Dokainish H et al. Circulation. 2004;109:24322439

Em/Am E/Em (septum) E/Em (lateral)

12 <8 <10

<1 - -

<1 >15 >10

<<1 -

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