CET CET Hemodynamic Assessment & Measurements 1 — Questions and Answers
Question 1: Using the simplified Bernoulli equation, what is the pressure gradient across a valve if the peak velocity is 4 m/s?
- 16 mmHg
- 32 mmHg
- 48 mmHg
- 64 mmHg (Correct answer)
Correct answer: 64 mmHg
The simplified Bernoulli equation is ΔP = 4V², so ΔP = 4 × (4)² = 4 × 16 = 64 mmHg.
Question 2: Which Doppler method is the standard for estimating pulmonary artery systolic pressure non-invasively?
- Pulmonary valve acceleration time
- Tricuspid regurgitation peak velocity plus estimated right atrial pressure (Correct answer)
- Pulmonary artery end-diastolic velocity
- Ratio of mitral E to tissue Doppler e' velocity
Correct answer: Tricuspid regurgitation peak velocity plus estimated right atrial pressure
PASP = 4(TRV)² + estimated RAP; the peak TR velocity is squared and multiplied by 4 (Bernoulli) and added to estimated right atrial pressure.
Question 3: What does a stroke volume (SV) calculation using the LVOT method require?
- Peak mitral E velocity and deceleration time
- LVOT diameter and LVOT velocity-time integral (VTI) (Correct answer)
- Peak aortic velocity and mean gradient
- Left ventricular end-diastolic and end-systolic volumes
Correct answer: LVOT diameter and LVOT velocity-time integral (VTI)
Stroke volume via LVOT = CSA × VTI, where CSA = π(D/2)² derived from the LVOT diameter, and VTI is traced from pulsed-wave Doppler at the LVOT.
Question 4: Which tissue Doppler parameter is most commonly used to estimate left ventricular filling pressures non-invasively?
- Mitral annular S' velocity
- E/e' ratio (mitral E velocity divided by tissue Doppler e' velocity) (Correct answer)
- Peak tricuspid annular systolic velocity
- Peak pulmonary venous S velocity
Correct answer: E/e' ratio (mitral E velocity divided by tissue Doppler e' velocity)
The E/e' ratio correlates with mean left atrial pressure; E/e' >14 using the average of septal and lateral e' suggests elevated LV filling pressures.
Question 5: What is the normal range for left ventricular ejection fraction (LVEF) measured by echocardiography?
- 40–50%
- 45–55%
- 52–72% (Correct answer)
- 60–75%
Correct answer: 52–72%
Normal LVEF is ≥52% in men and ≥54% in women per current ASE/EACVI guidelines, with 52–72% representing the normal range.
Question 6: The continuity equation is used to calculate which cardiac measurement?
- Pulmonary artery systolic pressure
- Left ventricular end-diastolic pressure
- Aortic valve area (AVA) (Correct answer)
- Mitral valve area by PHT
Correct answer: Aortic valve area (AVA)
The continuity equation (AVA = LVOT CSA × LVOT VTI / AV VTI) calculates aortic valve area based on conservation of flow across the LVOT and aortic valve.
CET CET Hemodynamic Assessment & Measurements 1
Using the simplified Bernoulli equation, what is the pressure gradient across a valve if the peak velocity is 4 m/s?