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Applied Cardiovascular > Evaluation of Systolic Function > Flashcards

Evaluation of Systolic Function Flashcards

Week 6

1
Q

This is what the ventricles have in them prior to the atria emptying into the ventricles.

A

Preload

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2
Q

According to ____, increasing initial muscle length will result in no change or a reduction in the force of contraction.

A

Frank-Starling law

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3
Q

As preload ____ the LV fibers will lengthen in diastole and the force of systolic contraction will ____.

A

Increases; increases

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4
Q

____ is commonly estimated as EDP (or end-diastolic pressure or volume).

A

Preload

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5
Q

The ability of the heart to contract is affected by:

A

Afterload and Contractility (inotropic)

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6
Q

The force ventricles face when contracting in systole

A

Afterload

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7
Q

Afterload is ____ related to ventricular systolic pressure, ventricular radius, and is ____ related to ventricular thickness

A

Directly; inversely

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8
Q

An increase in afterload will result in a reduced ventricular force and velocity of contraction, leading to an ____ in end systolic volume. Causing the ventricle to thicken

A

Increase

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9
Q

The force or energy expended on the heart muscle resulting in contraction.

A

Contractility (inotropic)

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10
Q

Dobutamine is an example of a positive ____ agent.

A

Inotropic

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11
Q

____ ____ (chronotropic) is expressed as beats per minute (BPM).

A

Heart rate

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12
Q

A heart rate of < 60 BPM is considered ____.

A

Bradycardia

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13
Q

A heart rate of > 100 BPM is considered ____.

A

Tachycardia

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14
Q

Increase HR = ____ CO

A

Increase

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15
Q

What is the formula for CO?

A

CO = Stroke volume (SV) x HR

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16
Q

Intrinsic contractility is the intensity of its active state, or how much ____ is available and actin-myosin interactions.

A

CA+

17
Q

With higher heart rate, calcium levels may be higher within the muscle cells, and therefore the force of contraction will ____.

A

Increase

18
Q

How to we quantitatively measure RV systolic function?

A
  • Measure a length and width of the RV when enlarged
  • RV TDI (Measure the S’)
19
Q

When measuring RV TDI, S’ > ____ cm/s represents normal RV function

A

10 cm/s

20
Q

For a Quantitative assessment of the LV use:

A
  • M-mode at the mid-papillary level
  • Teichholtz
  • Simpsons
  • Doppler if MR is present (dP/dt)
21
Q

____ measures of the rate of rise of ventricular pressure during IVCT.

A

dP/dT

22
Q

dP/dT is calculated by dividing the change in ____ by the change in ____.

A

Pressure; time

23
Q

If left ventricular systolic function is normal, dP/dt would be > ____.

A

1200 or .27 msec.

24
Q

If left ventricular systolic function is mild-moderately dysfunctional, dP/dt would be ____.

A

800-1200

25
Q

If left ventricular systolic function is severly dysfunctional, dP/dt would be < ____.

A

< 800 or > 32 msec

26
Q

If a patient has a WMA (wall motion abnormality) then the ____ cannot be accurately calculated.

A

LV

27
Q

____ ____ are when muscle segments are not moving BUT it has nothing to do with disease of the coronary artery.

A

Nonischemic WMA’s

28
Q

Nonischemic WMA’s are usually noted when there is a ____ present.

A

LBBB (left bundle branch block)

29
Q

An ____ alters the sequence of activation and the sequence of contraction of the LV.

A

LBBB (left bundle branch block)

30
Q

Following machine settings can optimize endocardial definition:

A
  • transducer frequency
  • gain
  • gray-scale settings
  • focus
  • harmonics
  • contrast (if necessary)
31
Q

____ can detect inducible ischemia at earlier stages than visual estimates can.

A

Strain rate imaging

32
Q

Strain rate imaging can determine different ____ viability states.

A

Myocardial

33
Q

What is the strain protocol?

A
  • PLAX
  • PSAX – LV
  • Apical 4
  • Apical 2
  • Apical 3
  • Aortic valve CW with valve click
  • PW of MVI
  • Color to assess for MR
34
Q

What are the two ways to assess strain?

A
  • Global Longitudinal Strain (GLS)
  • Regional Strain patterns
35
Q

A normal Global Longitudinal Strain (GLS) is ____ - ____%

A

-15 - -20 %

36
Q

A reduced Global Longitudinal Strain (GLS) is when peak strain is less than ____%

A

-15

37
Q
A

Applied Cardiovascular (12 decks)

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