Echo results help!

[clairegrps]

Hi,

I am from the UK and currently trying to interpret my echocardiogram report, any help would be gratefully received!

MMode/2D Measurements & Calculations:

EDV (teich): 96.8 ml
LAA: 20.8 cm 2
RAA: 11.1cm 2

Doppler Measurements & Calculations:

MV E max vel: 65.9cm/sec
MV A max vel: 94.8 cm/sec
MV E/A: 0.69
MV dec time: 0.30 sec
Ao V2 max: 144.1 cm/sec
Ao max PG: 8.3 mmHg
LV V1 max PG: 3.2mmHg
LV V1 max: 89.3cm/sec
MV/EA: 0.69
PA V2 max: 104.7cm/sec
PA max PG: 4.4mmHg

[djd1990]

It appears you've only been given a rather small amount of the information accumulated on a standard echo (either that or you've only provided a small portion of it here). From what you have provided the one big thing that jumps out is that you have grade 1 diastolic dysfunction. Diastole is the portion of the cardiac cycle when the ventricles fill with blood in between beats. You have grade 1 diastolic dysfunction because your E/A ratio is <1 and your deceleration time is prolonged. This reflects an impairment in the relaxation of the left ventricle.

Normally, what happens is that after systole (when your left ventricle pumps blood out to the rest of the body) the volume inside the LV drops and thus the pressure drops. This drop in pressure leads to the pressure gradient between the left atrium (from which oxygenated blood  fills into the left ventricle) and left ventricle increasing, triggering the opening of the mitral valve and an inflow of blood.  The point when that pressure gradient is maximized you achieve max velocity of the inflowing blood. This is depicted by a big wave on an echo Doppler known as the E-wave (for early peak filling). Then, as blood fills in the LV the LV pressure rises until it's back to equal pressure with the left atrium and filling essentially stops or becomes incredibly minimal. The point from the E-max to the end of early filling is the "deceleration time." If the LV has impaired relaxation the rate of filling is reduced (due to the reduced LA:LV pressure gradient) and the deceleration time is prolonged, as it takes longer to fill and re-raise pressure to equalization with LA pressure. Later there is secondary filling via an atrial contraction, and it will be larger if early filling was inadequate. Thus, in grade 1 diastolic dysfunction the A-wave is larger than normal as compensation for the E-wave being abnormally reduced. You end up with a combo of reduced E, E/A ratio 240ms). Your E/A is 0.69 and your deceleration time is 300ms.

Diastolic dysfunction has many causes, the most common of which are untreated chronic hypertension. However, mild diastolic dysfunction can also be seen as a nearly normal part of aging, so if you are a senior this may simply be a reflection of age. There are a myriad of other issues that could potentially be blamed as well. It would be important to know both the reason you took the echo in the first place, as well as getting to see the geometric and functional parameters pertaining to your left ventricle. If there is left ventricular hypertrophy this could (although not likely) be a case of something called hypetrophic cardiomyopathy. But like I said, high blood pressure, old age, and a series of other issues can cause this as well.

[clairegrps]

Thanks for all of that information, I have a family history of Dilated Cardiomyopathy and my daughter is 10 years post transplant due to Dilated Cardiomyopathy since birth.

I'm 55, if that affects things at all! This is the rest of the report and I wondered if you could say if there is anything else I should know.

MMode/2D Measurements & Calculations:
RVDd: 3.4cm
Ao Root Area: 8.1cm2
as: Aorta Diam: 4.0cm
ESV(Teich):42.4ml
IVSd: 1.0cm
LVIDs: 3.2cm
Ao root diam: 3.2cm
FS: 29.3%
LVIDd: 4.6cm
LVPWd: 0.62cm

Ejection fraction: 50-55%

Thanks!