Hi, Is the any guidelines for echocardiography were range values for standard echo measurements are included in patients with hypertension? e.g: interventricular septum or LAA velocity?
Thanks
Thank you very much, soontare. I am interested for Humans this time.
Hypertensive patients cannot have separate echo Doppler measurements. We try to find out how much of abnormalities/ deviations have occurred from the normal expected values.
Simplest thing is looking at thickness of IVS and LVFW. Normal values are 7 to 10 mms depending on BSA. Values above 11 mms indicate LVH. Better refinements are possible if it is indexed with body surface area. LV mass can also be calculated and compared with the nonogram.
With onset of diastolic dysfunction, LA tend to get dilated. LA Volume Index is a well validated measurement. Even simple LA measurement ( exceeding 45 mms, in absence of MR) Is fairly sensitive.
Spectral Mitral inflow velocity further detects and quantifies diastolic dysfunction. Height of E, E/ A ratio and E deceleration time are useful. Tissue Doppler parameters, especially E/ e prime accurately predicts Pulmonary capillary wedge pressure.
Dilated aortic root and Mild AR could be ancillary findings.
Uncontrolled HTN can lead to ventricular remodelling and HF with reduced EF, in later stages. It can happen with or without an MI.
First acqire good quality M -MODE image, Mesure IVS,LVID AND PW in diastole ,calculate LV mass(incorporated in most echo machines,then calculate PWT( posterior wall thickness by using formula (2xPWd)/LVd. Normal range is 0.32-0.42.if LV mass and RWT are high then its Concentric LVH,If LV mass is high and RWT is less than 0.32 then it is Ecentric LVH,if LV mass is Norma and RWT is high then it is Concentric remodelling.se this for evaluating all LVH.I use speckle tracking 2D-STE to evaluate all hypertensives(both L V and LA assessed.
IVS measurments are used in hypertension to ascertain LVH and degree of LVH.Similarly its useful to defferentiate Athletic heart,cardimyopathy.LAA velocity is used all patients who have the risk factor for AF.By using this velocity one can predict who might develop F in future and also if LAA velocity is low then chances of clot in LAA is high and vice versa.Its also my observation study of 3 yrs follow up that in AF patients with subtherapuetic INR / not on any anticoagulants if LAA EF and LAA velocity are good then chances of developing LAA clot is rare.Normal early diastolic velocity of LAA is 20-40cms/sec,Late diatolic velocity is 50-60cms/sec Systolic velocity is 40-50cms/sec.
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