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In AR think beyond LVEF - think LVOT SV π RVOT SVπ«#volumetrics #echomath
In AR, LVOT SV > RVOT SV
RegVol AR = LVOT SV - RVOT SV
RegFr AR = RegVol AR / LVOT SV
π if no MR, LV SV ~ LVOT SV
π if no TR, RV SV ~ RVOT SV
#echofirst @NMerke
Aortic regurgitation: why can EF be misleading?
In severe aortic regurgitation, the LV ejects blood in two directions: forward into the aorta and backward into the LV.
That changes how we interpret stroke volume and EF.
β¬ Acute severe AR: Total stroke volume rises, but forward stroke volume falls. LVEDP rises sharply.
π§ Chronic compensated AR: LV dilates and develops eccentric hypertrophy. EDV increases, allowing both total and forward stroke volume to rise while filling pressure remains relatively normal.
π© Chronic decompensated AR: LV contractile function deteriorates. ESV rises, EF falls, forward stroke volume falls, and LV filling pressure rises again.
π₯ After valve replacement: EF may initially fall because the low-resistance regurgitant pathway has been eliminated. This does not necessarily mean the LV has worsened. Forward stroke volume improves, and EF can recover with remodeling.
Key point: In severe AR, a normal or high EF does not necessarily mean normal LV function. The LV is ejecting blood both forward and back into the ventricle.
#Cardiology
Happy to join #echofirst Jedi master @fiore_corrado soon at his Meeting: Echo Surgery Lab at Rome, although just online.. @DHZB_Akademie @dhzcharite
#volumetrics rules....
#EchoMath is the way
#DontGetFooledByColorJet
@echo_batman Maybe we are on the verge towards new frontiers in #echofirst and #VHD maybe there will a future with less #volumetrics #EchoMath
@bwoody58 right, thinking alike. #EchoMath is needed in #echofirst
If we consider a
πforward SV of 60 ml
π LV Stroke volume would be 204 ml;
πIf LV EF 60 %
LVEDV 340 ml and LVESV 136 ml
What do you think about this Reg. Volume in primary MR?
LV EF is reported to be 60%
#echofirst #EchoMath
@echo_batman @jaumeaguero @iamritu @echo_stepbystep @JournalASEcho @ASE360 @DocStrom @amerjohri @rajdoc2005 @mswami001 @LucySafi @DavidWienerMD @onco_cardiology @GWhalleyPhD @AHagendorff Please donβt forget #echofirst volumetrics power πͺ #EchoMath
@alexsfelixecho Excellence of imaging! β¨ #3DEcho and #EchoMath !! π€ thank you for sharing this tricky doppler case! ππ»
@DrRajeshG1 great #echofirst teaching point, but we should never forget to go for standardized protocol. Mi big fan of #EchoMath & #Volumetrics look always at LV linear dimensions (GL ignore volumes), LVOT SV and over all LV stroke volume and LAVI, e-wave inflow > 1,2 m/s ...
Great caseππΌ beautiful and careful #3DEcho and #EchoMath οΏ½οΏ½
Not seldom mixed valve challenge! International GL do not provide definitive answers.
Looks like pure secondary moderate MR. Dilated LV but normal EF and strainsβ‘οΈ big hope for remodeling TIW I go for only Ao surgery. Thanks for sharing and challenging π
π€π«Άπ»
π Moderate functional MR based on PISA - Reg Vol = 30ml ERO: 0,2cm2
πHow about confirmation with volumetric calculation π #EchoMath π€?
π§΅Thread 4/7
#echofirst
@HanCardiomd @drozgeozden @iceman_ex @OxMarchenko @EACVIPresident @nat_echo @almasthela @Lolasan07257061 @NMerke @VazyurVasquez @Giulia_Vinco @vass_vassiliou
3. MR #echofirst needs to go #Volumetrics #EchoMath
#EchoDGK2024
πRegistration to See more of it: https://t.co/UmkZQvRGRb
@senguptasp @ASE360 @EACVIPresident @IAEecho Congratulations ! Have fun π€© like only echocardiographer can have! Make #echofirst #volumerty #EchoMath big!
πOne small step for manβ¦..
πOne giant leap for #echofirst
ππ
Creating my new Tag π·οΈ in EchoPac
#EchoMath original by @NMerke
@echo_stepbystep @AHagendorff @StellEkaterina
Now #echofirst goes #EchoMath
LV: LV SV 78 ml, LVOT SV 71 ml
RV: RV SV 121 ml, RVOT SV 71 ml
Regurgitation of TR is 50 ml
PISA EROA Reg. Volume 43 ml
#echofirst can try PISA in TR, but ONLY if convergent zone is hemispherical as we us mathematical equation to calculate βοΈ
In most of relevant TR cases PISA is not feasible
#echofirst basics in severity grading starts with volumes on the left side to know what is leaving left side b4 π at right side to β οΈ TR
@NMerke @echo_stepbystep @dr_benoy_n_shah @KemalogluOz @AntonioBarros_ @marciomp50 @GoncalvesCortez @StellEkaterina Thank you for your kind words π€ππΌπ!
You are a master and a great friend, an example to follow πͺπ½ on #echofirst.
Your contribution to #3Deducation and #EchoMath is amazing, definitely a pleasure to learn from your posts always.ππ
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