LA AP
Left atrium anterior-posterior dimension
- PLAX (Parasternal long axis).
- End-systole (ECG: The end of T wave).
- Measured at the level of the aortic sinuses.
- Perpendicular to the long axis of the LA posterior wall.
LA volume
Left atrial volume (Biplane)
- A4C (Apical 4 chamber) and A2C (Apical 2 chamber)
- End-systole (ECG: The end of T wave).
- Preferred technique is method of disk summation (modified biplane).
- Trace the LA inner border, excluding the area under the MV annulus, pulmonary veins, and LA appendage from the A4C and A2C views.
RA major
Right atrium major axis dimension
- Length of righ atrium
- A4C (RV focused).
- End-systole (ECG: The end of T wave).
- Length from center of valve annulus to center of superior RA wall
- Parallel to intraatrial septum.
RA minor
Right atrium minor axis dimension
- Width of right atrium.
- A4C (RV focused).
- End-systole (ECG: The end of T wave).
- Distance width from lateral wall to intraatrial septum (Mid-atrial level).
RA volume
Right atrium volume (Single plane)
- Right atrium volume is measured from one view (A4C).
- Left atrium volume is measured from two views (A4C, A2C).
- A4C (RV focused).
- End-systole (ECG: The end of T wave).
- Single view area-length or disk summation technique should be used.
IVCdiameter
Inferior vena cava diameter
- Maxiumum inferior vena cava diameter.
- It´s used to calculate: RAP and IVCcollaps
- SC window (long axis IVC).
- Measured perpendicular to the long axis of the IVC at end-expiration.
- Just proximal to the junction of the hepatic veins that lie
- approximately 1-3cm proximal to the ostium of the right atrium.
IVCsniff
Inferior vena cava diamater during sniff
- Collapsibilitz of inferior vena cava during sniff.
- It´s used to calculate: IVCcollaps
- SC window (long axis IVC).
- Measure smallest diameter of IVC during sniff.
- Approximately 1-3cm proximal to the ostium of the right atrium.
IVCcollaps
Inferior vena cava collapsibility
- IVCcollaps = (IVCdiameter - IVCsniff) / IVCdiameter x 100
- The collapsibility index of inferior vena cava.
- It´s used to calculate: RAP.
RAP
Right atrial pressure
- SC window (long axis IVC).
- RAP is calculated by values of inferior vena cava (IVCdiameter and IVCcollaps).
References:
Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)
Recommendations for the Evaluation of LV Diastolic Function by Echocardiography: An Update from the ASE and EACVI (2016)
Recommendations on the use of echocardiography in adult hypertension: a report from the EACVI and the ASE (2015)
Recommendations on the Echocardiographic Assessment of Aortic Valve Stenosis: A Focused Update from the EACVI and the ASE (2017)
ASE Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation (2017)
Guidelines for performing a comprehensive TTE examination in adults: Recommendations from the ASE (2018)
Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: ASE, EACVI, ESC, CSE (2010)
Guidelines for the diagnosis and management of acute pulmonary embolism ESC, ERS (2019)
Echocardiography in aortic diseases: EAE recommendations for clinical practice (2010)
Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice (2009)
ESSENTIAL ECHOCARDIOGRAPHY A Companion to Braunwald’s Heart Disease
Coronary Artery Territories (Echocardiography Illustrated Book 4)