How can I interpret the results of an echocardiogram to assess left ventricular function?

Interpreting echocardiogram results to assess left ventricular (LV) function involves evaluating several key parameters that reflect the heart's pumping ability and structural integrity.

• Left ventricular ejection fraction (LVEF) is the primary quantitative measure of systolic function, representing the percentage of blood ejected from the LV with each contraction. An LVEF of 55-70% is generally considered normal, with values below 40% indicating systolic dysfunction and heart failure NICE NG106.
• LV volumes and dimensions measured in diastole and systole provide insight into chamber size and remodeling. Increased LV end-diastolic volume or diameter suggests dilatation, often associated with impaired function NICE NG106.
• Wall motion abnormalities detected visually or by strain imaging indicate regional dysfunction, which may reflect ischaemia or infarction Grimaldi et al. 2013.
• Diastolic function assessment includes parameters such as E/A ratio, E/e' ratio, and left atrial size, which help evaluate LV filling pressures and compliance, important in heart failure with preserved ejection fraction NICE NG106.
• Valvular assessment is integral since valvular disease can impact LV function; echocardiography evaluates valve morphology and severity of regurgitation or stenosis, which may contribute to LV dysfunction (Grimaldi et al., 2013; NICE NG208).
• Global longitudinal strain (GLS) is an advanced echocardiographic measure increasingly used to detect subtle LV dysfunction before LVEF declines, providing prognostic information Grimaldi et al. 2013.

In summary, to interpret LV function on echocardiogram, focus on LVEF, LV size and volumes, wall motion, diastolic parameters, and valvular status. Combining these findings allows a comprehensive assessment of LV performance and guides clinical management in line with NICE guidelines and current echocardiographic practice (NG106; NG208; Grimaldi et al., 2013).