Left ventricle size

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The objective of this chapter is to determine if the left ventricle is:    


-dilated: mildly, moderately or severely

-normal size

The left ventricle diameter is measured in parasternal long axis, at the tip of the mitral leaflets, at the interface blood-internall wall.


Diastolic diameter

LVED: left ventricle end-diastolic diameter, is the most important measurement. It is measured at end diastole, on the frame after mitral closure. It normally corresponds to the largest cardiac dimension.

LVED measurement.jpg

Systolic diameter

LVES: left ventricle end-systolic diameter, is measured at end systole, on the frame preceding mitral valve opening. It corresponds to the smallest cardiac dimension.

LVES measurement.jpg

M-mode measurements

The LV dimensions can be measured in M-mode. This imaging modality allows the visualization of each structure depending on the time and gives a better image resolution than 2D imaging. However you must be sure that the imaging beam is cutting perpendicularly the long axis of the left ventricle or you will overestimate the LV size.

LV measurement Mmode.jpg

Normal and abnormal values

LVED (mm) Normal Mildly dilated Moderately dilated Severely dilated
Men 42-59 60-63 64-68 >69
Women 39-53 54-57 58-61 >62

Pitfalls of LV diameter measurement


  • Be careful to exclude the chordae and papillary muscle from the measurement
  • Measure perpendicularly to the long axis of the left ventricle
  • Your PSL view must be parallel to the long axis of the LV: the septum and posterior wall should be parallel, and you should not visualize the LV apex

Left ventricle shortening fraction

With the left ventricle end-diastolic and end-systolic diameters, you will be able to calculate the shortening fraction. The shortening fraction reflects the left ventricle systolic function, but is valid only if the left ventricle geometry is normal and in the absence of wall motion abnormality.


Shortening fraction = -------------------------- x 100



Shortening fraction  %
Normal 25-45
Mild 20-25
Moderate 15-20
Severe <15
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