Comprehensive Echocardiographic Assessment of Cardiac Function

A standard transthoracic B-mode echocardiography/Doppler examination was carried out with commercially available ultrasound systems, comprising “GE Medical Systems” (General Electric, Freiburg, Germany), “Aplio 400” (Canon Medical Systems, Tochigi, Japan), and “Vivid E9” (General Electric Vingmed Ultrasound AS, Horten, Norway), in accordance with the current guidelines of the American Society of Echocardiography/European Association of Cardiovascular Imaging [37 (link)]. The echocardiographic Doppler assessments were focused on LV systolic and diastolic functions and LV hypertrophy (LVH) [38 (link)]. Cardiac volumes, left ventricular (LV) ejection fractions (LVEF), and left atrial volume indices (LAVI) were measured using the Simpson method. The LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) were normalized to the body surface area (BSA) and given as the LVEDV index (LVEDVi) and LVESV index (LVESVi). LVH was determined by the conventional echo criteria (LV mass/body surface area ≥125 g/m² in males or ≥110 g/m² in females). The early diastolic wave velocity (E) and mitral annular early diastolic velocity, given as averaged septal and lateral e` (e`) and E/e’ ratios, were determined by a pulsed-wave Doppler and a spectral tissue Doppler obtained from the apical 4-chamber view.