In 2019 The British Society of Echo released new guidelines and reference intervals. Due to the pandemic Diagnostic Cardiology across Sunderland and South Tyneside and Sunderland NHS Foundation Trust had delayed the full transition over to the new reporting terminology.

By Monday 11th July we aim to change over fully to the new guidance and reporting terminology.

Please read, familiarise yourselves with these and keep for reference.

The way that Cardiac Physiologists will be describing and reporting the Echocardiogram will change very slightly, but will not take away from all of the clinical information that has always been present in reports.

The guidance boundaries have changes so what was once normal could not be abnormal and vice versa and most measurements now will be indexed to patient BSA.

Full details and background are below:

The main changes to be aware of from the document are highlighted below.

Left ventricular ejection fraction

The main point from this section is to note that the ‘Good, Mild , Moderate and Severe ‘ scale is to be replaced with:

Normal >55% , Low normal 50-55% , Impaired 36-49% , Severe <35%

Linear left ventricular dimensions and LV Mass -

Dimensions are corrected / indexed to the patient BSA

New cut off ranges for normal, mild ,moderate severe dilatation

LVH will no longer be graded as Mild, moderate and Severe , but replaced with a descriptive of overall mass and relative thickness (see document for further information)

Left Ventricular volumes

Updated ranges for Systolic and diastolic volume and indexed variations

Left Atrial Volume

Reference limits for LA volume are the same for males and females.

  • An LA volume index (LAVi) of <34 mL/m2 is normal.
  • An LAVi between 34 and 38 mL/m2 is a borderline result.
  • An LAVi of >38 mL/m2 is abnormal.

(Routine use of linear LA dimensions is not encouraged, but may be used in some clinical scenarios)

The right heart

Updated reference limits for linear dimensions are substantially different from previous BSE guidance and contemporary joint ASE/EACVI guidelines.

Aortic root dimensions

All values should be indexed to height and not BSA.

Tissue Doppler

Values for the left heart should be obtained as the average of medial and lateral mitral annular systolic velocities, and obtained during a breath hold in end-expiration. Values are similar for both men and women, but vary according to age

Numbers quoted as S’ (normal ranges on chart)

Return to Cardiology