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. 2018 Aug 2;84(Suppl 1):46–56. doi: 10.1038/s41390-018-0077-x

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© The Author(s) 2018

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 3 — Assessment of left heart volume loading. (1) Measurement of diastolic flow in the left pulmonary artery. a Normal situation without ductal left-to-right shunting. b Illustrates forward diastolic flow in the presence of significant left-to-right ductal flow. (2) Measurement of LVO: increased LVO in the setting of a PDA indicated increased pulmonary venous return. (3) Measurement of LV diameter in diastole: increased LV diameter is another surrogate marker for increased LV end-diastolic volume. (4) LA:Ao ratio: atrial enlargement can be indexed to a relatively fixed aortic root diameter to further estimate in degree of increased LA volume