Table 2.
Semi-quantitative systolic ventricular function measures that might be used by the clinician with more evolved training in cardiac POCUS. Normative values are taken from the available literature on the topic [32–45] and represent the best reference data available so far, although, in some cases, specific level for a different class of patients’ age are lacking
| Parameter | View | Measurement | Reference values |
|---|---|---|---|
| LV fraction shortening (FS%) | PSAX, PLAX, (2D or M mode) | LV intraluminal diameter change | 28–46% for all ages |
| LV ejection fraction (Simpson’s method) | A4C, A2C | Percentage change of LV volume between end-diastole and end-systole | 55–80% for all ages |
| E-point septal separation (EPSS) | PLAX (2D or M mode) | Distance between anterior leaflet of the mitral valve and intraventricular septum during the diastolic phase. This measurement is associated with LV systolic volume. | > 7 mm in adults predictive of severe LV dysfunction * |
| LV output (stroke volume) | A5C, PLAX | Product of VTI measured by pulse wave Doppler at LVOT in A5C and LVOT cross-sectional area measured in PLAX |
Z-scores available for different ages and should be used; neonates: 150–400 ml/kg/min |
| Mitral annular plane systolic excursion (MAPSE) | A4C | Systolic excursion of lateral (or medial) mitral annulus toward apex to assess LV systolic function. |
Z-scores available for different ages and should be used; term neonates: > 8 mm (8–11 mm) Adults 12–14 mm (< 8 mm predictive of severe LV dysfunction) |
| RV output (stroke volume) | PSAX or sweep PLAX | Product of VTI measured by pulsed-wave Doppler at RVOT and RVOT cross-sectional area |
Z-scores available for different ages and should be used; neonates: 150–400 ml/kg/min |
| Tricuspid annular plane systolic excursion (TAPSE) | A4C | Systolic excursion of lateral (or medial) tricuspid annulus toward apex to assess RV systolic function. |
Term neonates: > 8 mm (8–11 mm) Children–Z-score available; generally > 12 mm (12–17 mm) Adults or grown-up children > 17 mm (17–25 mm) |
A4C Apical 4 chamber view, A5C Apical 5 chamber view, A2C Apical 2 chamber view, PSAX parasternal short-axis view, PLAX parasternal long-axis view, M mode motion mode, LV left ventricle, LVOT left ventricular outflow tract, VTI velocity time integral
*No data are available in neonates or children