ARDMS Echo Cardiac Hemodynamics 2 — Questions and Answers
Question 1: What is the normal range for left ventricular ejection fraction (LVEF) by echocardiography?
- 55–70% (Correct answer)
- 35–55%
- 40–60%
- 60–80%
Correct answer: 55–70%
Normal LVEF is generally accepted as 55–70% by biplane Simpson's method in current guidelines.
Question 2: Which index is most commonly used to assess LV diastolic function grade when E/A ratio is 0.8–2.0 and E/e' is borderline?
- Pulmonary vein systolic/diastolic ratio and TR velocity (Correct answer)
- IVRT alone
- Mitral A duration alone
- Peak A velocity alone
Correct answer: Pulmonary vein systolic/diastolic ratio and TR velocity
When E/A is borderline (0.8–2.0) and E/e' is indeterminate, guidelines recommend using TR velocity and pulmonary vein flow ratio to determine diastolic grade.
Question 3: What does the TAPSE measurement reflect in echocardiography?
- Right ventricular systolic function (Correct answer)
- Left ventricular systolic function
- Tricuspid valve area
- Pulmonary vein flow
Correct answer: Right ventricular systolic function
TAPSE (tricuspid annular plane systolic excursion) measures the longitudinal displacement of the tricuspid annulus and reflects RV systolic function.
Question 4: Which hemodynamic parameter is estimated from the diastolic deceleration time of the pulmonary regurgitation jet?
- Pulmonary artery diastolic pressure (Correct answer)
- Left atrial pressure
- Right ventricular end-diastolic pressure
- Pulmonary artery systolic pressure
Correct answer: Pulmonary artery diastolic pressure
Applying the Bernoulli equation to the end-diastolic pulmonary regurgitation velocity estimates pulmonary artery diastolic pressure.
Question 5: What does an LV dP/dt less than 1200 mmHg/s indicate in echocardiography?
- Reduced LV systolic function (Correct answer)
- Normal LV contractility
- Elevated preload
- Diastolic dysfunction
Correct answer: Reduced LV systolic function
LV dP/dt <1200 mmHg/s measured from the mitral regurgitation jet suggests impaired LV systolic contractility.
Question 6: In a patient with constrictive pericarditis, what respiratory variation pattern is expected in mitral E velocity?
- >25% variation with respiration (Correct answer)
- <10% variation with respiration
- Fixed high E velocity regardless of respiration
- Absent E velocity on expiration
Correct answer: >25% variation with respiration
Constrictive pericarditis causes ventricular interdependence, resulting in >25% respiratory variation in mitral E velocity.
ARDMS Echo Cardiac Hemodynamics 2
What is the normal range for left ventricular ejection fraction (LVEF) by echocardiography?