Left ventricle Michel Slama Amiens France. LV ventricle Ejection fraction Cardiac output Left ventricular filling pressure.

Slides:

Advertisements

Similar presentations

Assessment of left ventricular function

Advertisements

Echocardiographic Evaluation of LV Diastolic Function Natalie Bello, M.D. October 14, 2009.

Left Ventricular Pressure-Volume Loops

Lecture:10 Contractility, Stroke volume and Heart Failure

The Third & Fourth (S3 &S4) Chapter 9

Hemodynamic Monitoring

Weaning failure of cardiac origin

Congestive Heart Failure

Ventricular Pressure loop

Manoel Otávio da Costa Rocha UNIVERSIDADE FEDERAL DE MINAS GERAIS - FACULDADE DE MEDICINA PROGRAMA DE PÓS-GRADUAÇÃO EM CIÊNCIAS DA SAÚDE: INFECTOLOGIA.

CO - RELATION WITH ECG INTRA CARDIAC PRESSURES ASHOK MADRAS MEDICAL MISSION CHENNAI

CHAPTER II: CARDIAC MECHANICS Asst. Prof. Dr. Emre Hamurtekin EMU Faculty of Pharmacy.

TISSUE DOPPLER IMAGING

Non-Invasive Estimation of Filling Pressures of the Left Ventricle by Doppler. Correlation to Hemodynamic Measurement Dr. Jorge A. Lax Hospital GCBA Dr.

Assessment of Diastolic function by echo

1 Cardiac Pathophysiology Part B. 2 Heart Failure The heart as a pump is insufficient to meet the metabolic requirements of tissues. Can be due to: –

Bio-Med 350 Normal Heart Function and Congestive Heart Failure.

THE CARDIAC CYCLE.

Evaluation of Diastolic Dysfunction by Echocardiography

Investigator Investigator: Sharma Kattel, MBBS Mentor: Mentor: Yuji Saito, MD, PhD, FACP, FACC Department of Internal Medicine Sisters of Charity Hospital.

Diastolic Dysfunction as Diagnosed and Quantified by Echocardiography LAM-1965AO (07/13) For Broker/Dealer Use Only.

Ventricular Diastolic Filling and Function

Cardiovascular management

Heart sounds and intra- cardiac pressures.. Heart sounds: S1: Due to closure of mitral and tricuspid valves. S1: Due to closure of mitral and tricuspid.

TISSUE DOPPLER BASICS DR BIJILESH U.

The Relationship Between Renal Function and Cardiac Structure, Function, and Prognosis Following Myocardial Infarction: The VALIANT Echo Study Anil Verma,

Frank-Starling Mechanism

Echocardiography in ICU Michel Slama AmiensFrance LEVEL 1 basic LEVEL 2: advanced.

Definition and Classification of Shock

Guidelines for the Echocardiographic Assessment of

 By the end of this lecture the students are expected to:  Explain how cardiac contractility affect stroke volume.  Calculate CO using Fick’s principle.

The Relationship between Leukoaraiosis & Heart Function Hyung Suk Seo 1, Young Hen Lee 1, Sung Hwan Kim 2 Korea Univ., Ansan Hosp., Dept. of Radiology.

Events of the Cardiac Cycle Why did the blood flow across the valve? Desire - it wanted to Ability - it could do it Movement = Desire X Ability Flow.

Diastolic Heart Failure

Date of download: 6/24/2016 Copyright © The American College of Cardiology. All rights reserved. From: Left ventricular systolic and diastolic function.

Date of download: 7/10/2016 Copyright © The American College of Cardiology. All rights reserved. From: Echocardiography for Percutaneous Heart Pumps J.

Cardiac Function in Disease Robert A. Augustyniak, PhD

Diastology Patrick Feng, PGY1.

Supplementary Material

Heart & Thalassemia . R.Miri,MD, Interventional Cardiologist.

Basic Echo As I understand it… Dr Claudia Wong.

Heart Failure With Preserved Left Ventricular Function: Diagnostic and Therapeutic Challenges in Patients With Diastolic Heart Failure Michael N. Young,

DIASTOLIC DYSFUNCTION and DIASTOLIC HEART FAILURE

Normal physiology (control) is compared to that of acute mitral regurgitation (chordal rupture), compensated mitral regurgitation, and decompensated chronic.

Echocardiographic modalities for evaluation and risk stratification of heart failure patients. 3D indicates 3-dimensional; EF, ejection fraction; LA, left.

(A) The normal pulsed Doppler pattern seen with mitral valve inflow

Fig. 5. Left atrium (LA) function evaluation in a patient with severe asymptomatic mitral regurgitation (MR). The LA ejection fraction calculated by LA.

Treatment of Heart Failure With Preserved Ejection Fraction: Have We Been Pursuing the Wrong Paradigm? Gerard O. Oghlakian, MD, Ilke Sipahi, MD, James.

Nat. Rev. Cardiol. doi: /nrcardio

Diastolic heart failure

Diastolic heart failure in anaesthesia and critical care

Figure 2 Echocardiographic methods to estimate left atrial pressure

Figure 2 Results of diastolic stress testing

Alan G. Japp et al. JACC 2016;67: Differentiation of Athlete’s Heart From Early DCM by Myocardial Deformation Imaging Two-dimensional speckle.

Echocardiography findings in HFNEF

Incremental predictive value of CR after repetitive squatting exercise and FC from cardiopulmonary testing exercise results over clinical (red) and echocardiographic.

Nat. Rev. Cardiol. doi: /nrcardio

Treatment of Heart Failure With Preserved Ejection Fraction: Have We Been Pursuing the Wrong Paradigm? Gerard O. Oghlakian, MD, Ilke Sipahi, MD, James.

Cardiac cycle DR S.PARTHASARATHY MD., DA., DNB., DIP. DIAB. PhD, FICA, IDRA, Diploma in software based statistics.

Figure 6 The haemodynamic effects of

Definition and Classification of Shock

Romain Gallet et al. BTS 2016;1:14-28

Behnam N. Tehrani et al. JACC 2019;73:

Volatile anaesthetics and positive pressure ventilation reduce left atrial performance: a transthoracic echocardiographic study in young healthy adults

Patrick O’Gara et al. JIMG 2008;1:

Representative echocardiographic findings: women with HDP versus women with NCP. †P

Introduction; The Cardiovascular System (CVS)

Charanjit S. Rihal et al. JACC 2015;65:e7-e26

VEVO 3100 Mouse Cardiovascular Core Division of Cardiovascular Disease Department of Medicine, University of Alabama at Birmingham Core director: Ganesh.

Diastolic dysfunction in sickle cell

Presentation transcript:

Left ventricle Michel Slama Amiens France

LV ventricle Ejection fraction Cardiac output Left ventricular filling pressure

Ejection fraction : systolic function, contractility?

Shortening Fraction of LV Area Ejection Fraction Systolic Function LEVEL 1

Mitral valve opening

NB Shiller, Heart, 1996;75:17-26 Estimated and measured EF LEVEL 1

Pouleur, Am J Cardiol, 1983;52: Influence of afterload on EF HT, AS Septic Shock

Cardiac output

How to perform echocardiographic examination in shocked patient? Cardiac output TTE: LEVEL 2

How to perform echocardiographic examination in shocked patient? Cardiac output TTE: LEVEL 2

Diastolic function

LV relaxation

Pathophysiology Pressure Normal Diastolic dysfunction Volume

LVEDP LVEDV 18 mmHg

Mitral flow : how to record ? Pulsed Doppler Correct Alignement Small window At the tip of mitral valve Visible opening sound Settings et filters 100 mm/s Average of 3 measurements

Early filling Late filling Vitesses LAP LVP Velocies P1 – P2 = 4 x V 2

LV Pressure Mitral flow

Type I of Appleton relaxation impairement Early diastole Late diastole Vitesses LAP LVP Velocities

Decreased preload SOHN, JACC 1997 BASETNT

Ea Aa DTI Mitral annulus Minimum settings Normal values Ea > 8 cm/s et Ea / Aa > 1 Ea = 15 ± 4 cm/s Aa = 10 ± 3 cm/s

Mitral annulus movement Ea AaEa Aa normal Ea = 18cm/s Ea > Aa Relaxation impairement (HT) Ea = 7,5cm/s et Ea < Aa

Left atrial size LAV = 0,5 x L1 x L2 x L3

Practical approach to assess diastolic function E’ lateral E’ Septal LA volume E’ lateral>10cm/s E’ Septal>8cm/s LA volume<34 ml/m² E’ lateral>10cm/s E’ Septal>8cm/s LA volume>34 ml/m² E’ lateral<10cm/s E’ Septal<8cm/s LA volume>34 ml/m² Normal left ventricular relaxation Athlet’s heart or constriction Left ventricular dysfunction

PAOP (Wedge pressure)

E (Mitral flow) depends on PAOP and on LV relaxation E’ (TDI mitral annulus) evaluate LV relaxation (preload independent) E/Ea ratio depends on PAOP LEVEL 2

E/E’ ratio predicts PAOP LEVEL 2

Combes A Int Care Med 2004 E/Ea ICU, mechanical ventilation LEVEL 2

Other tools to evaluate cardiac function Speckle tracking and strain evaluation 3D imaging assessement of EF MAPSE S wave on TDI at the mitral annulus

Septic shock

Myocardial infarction with cardiogenic shock

Pulmonary oedema

Congestive heart failure with pulmonary oedema

Unexplained shock

Conclusion