ARDMS Echo Hemodynamic Assessment 3

Question 1

Left ventricular dP/dt can be estimated from echocardiography using:

Accepted Answer

The time for the MR jet velocity to rise from 1 m/s to 3 m/s (32/Δt mmHg/s)

Answer

Peak LV systolic pressure divided by ejection time

Answer

LV end-diastolic pressure × heart rate

Answer

LVOT VTI × systemic vascular resistance

Question 2

Which echocardiographic pattern reflects Grade III (restrictive) diastolic dysfunction?

Accepted Answer

E/A > 2 with shortened deceleration time (<160 ms) and elevated E/e' > 14

Answer

E/A < 0.8 with prolonged deceleration time

Answer

Normal E/A with normal E/e'

Answer

E/A 0.8–2 with indeterminate filling pressures

Question 3

Which finding on echo-guided hemodynamic assessment indicates fluid responsiveness?

Accepted Answer

IVC collapsibility index >18% in a mechanically ventilated patient or >50% in a spontaneously breathing patient

Answer

IVC diameter fixed at >2.5 cm with no respiratory variation

Answer

LVEF < 35% with dilated LV

Answer

Restrictive mitral inflow pattern

Question 4

The end-systolic pressure-volume relationship (ESPVR) is a load-independent measure of contractility. Which echo index best approximates it?

Accepted Answer

End-systolic elastance derived from pressure-volume analysis

Answer

Fractional shortening

Answer

E/A ratio

Answer

TAPSE

Question 5

In a patient with low-flow, low-gradient aortic stenosis (LVEF < 50%), dobutamine stress echo is used to:

Accepted Answer

Distinguish true severe AS (fixed, small AVA) from pseudo-severe AS (AVA normalizes with increased flow)

Answer

Assess coronary artery disease by wall motion abnormalities only

Answer

Measure pulmonary artery pressure at rest

Answer

Evaluate diastolic dysfunction severity

Question 6

What is the normal resting mean pulmonary artery pressure (mPAP) threshold above which pulmonary hypertension is diagnosed?

Accepted Answer

>20 mmHg

Answer

>25 mmHg

Answer

>30 mmHg

Answer

>35 mmHg