DK2985_C000 1..28 - AlSharqia Echo Club

Quantitative Echocardiography 95Figure 5.6 (A) Transthoracic echocardiography recommended M-mode measurement of ventricular, aortic and atrial dimensions.(B–D) Equivalent transesophageal echocardiographic measurements from a long-axis transgastric view (AWT, anterior wall thicknessin diastole ¼ A and in systole ¼ B; D, diastole; EKG, electrocardiogram; LA, left atrium; LV, left ventricle; LVD, left ventricular diameterin diastole ¼ A and in systole ¼ B; PWT, posterior wall thickness in diastole ¼ A and in systole ¼ B; S, systole; SWT, septal wallthickness in diastole ¼ A and in systole ¼ B).Measurement of the Left VentricleThe major, or long, axis of the LV can be measuredfrom a four-chamber view in the mid-esophageal positionat 08, from inner edge of the true apical endocardium to themiddle of the mitral valve annulus as determined from thebase of the two mitral valve leaflets.The minor, or short, axis of the LV is measured in thelateral to septal plane perpendicular to the hypotheticallong axis at a point located at the junction between thebasal and the middle third of the LV (Fig. 5.8). Alternatively,the minor axis has been obtained from the longaxis-aortic view in the mid-esophageal position at 1358perpendicular to the hypothetical long axis at the level ofchordal—leaflet junction or at the tips of the mitral valveleaflets. This different anatomical, rather than geometrical,landmark results in different reference values. Finally,the minor axis can also be measured in the anteroseptal–inferolateral plane from a left ventricular short axistransgastric view at 08 at the level of the chordae tendinaeor at the papillary muscles (Fig. 5.9).Measurement of the Right VentricleThe major, or long, axis of the right ventricle (RV) canbe measured from a four-chamber view in the midesophagealposition at 08, from inner edge of the trueapical endocardium to the middle of the tricuspid valve(TV) annulus as determined from the base of the TV leaflets(Fig. 5.10).The minor, or short, axis of the right ventricle (RV) ismeasured in the lateral to septal plane perpendicular tothe hypothetical long axis at a point located at the junctionbetween the basal and the middle third of the RV. Alternatively,the minor axis has been obtained from the longaxis-aortic view in the mid-esophageal position at 1358perpendicular to the hypothetical long axis, at thesame level as for the minor axis of the LV, i.e. at the