DK2985_C000 1..28 - AlSharqia Echo Club

164 Transesophageal Echocardiography(A)BASAL(B)IASISILALA(C)MID(D)ASRVISIILLVALA(E)APICAL(F)LADRCALCXISALFigure 8.8 Basal (A, B), mid (C, D), and apical (E, F) short-axis transgastric views in a 49-year-old female (A, anterior;AL, anterolateral; AS, anteroseptal; I, inferior; IL, inferolateral; IS, inferoseptal; L, lateral; LAD, left anterior descending; LCX, leftcircumflex artery; LV, left ventricle; RCA, right coronary artery; RV, right ventricle; S, septal).ejection fraction using the average of several left ventriculardiameters from multiple views (measured at thebase, mid-, and distal third of the LV) combined withthe left ventricular long-axis fractional shorteningTable 8.1Wall Motion Scoring SystemMovement Radial displacement ThickeningNormal ¼ 1 .30% þþHypokinesia ¼ 2 0–30% þAkinesia ¼ 3 0% NoneDyskinesia ¼ 4 Systolic lengthening Systolic thinning(estimated from the descent of the mitral annulustowards the apex) (10). Doerr et al. (10) found a good correlationbetween the ejection fraction measured with thismethod and the ejection fraction measured with TTE(r ¼ 0.83).The left ventricular end-systolic diameter is a reliableindicator of global left ventricular contractile function,hemodynamic, and volume status. Leung et al. (7) haveshown that left ventricular cavity obliteration is a highlysensitive indicator of hypovolemia. A good correlationhas also been observed between left ventricular area asmeasured on the mid-papillary short-axis view and thatobtained by the radionuclide approach. A very good