End-sytolic volume

The end-systolic volume (ESV) is referred to as the volume of blood in the left or right ventricle at the end of the systolic ejection phase immediately before the beginning of diastole or ventricular filling.

Terminology

The end-systolic volume index (ESVI) is referred to as the end-systolic volume (ESV) corrected for the body surface area (BSA).

Usage

In addition to the end-diastolic volume, the end-systolic volume (ESV) is an essential parameter used for the assessment of cardiac function and the calculation of the respective stroke volumes and ejection fraction.

Measurement

MRI

Widely- used postprocessing software solutions for cardiac MRI employ a combination of semi-automated feature recognition and manual contour correction based on Simpson’s method (“summation of disks”) .

The end-systolic volume (ESV) is determined by the sum of the computed left/right ventricular cross-sectional areas determined by the endocardial contours at the end of the systolic ejection phase chosen as the images with the smallest blood volume accounting for slice thickness and gap .

End-systolic volume index (ESVI) is calculated as: ESVI [mL/m] = ESV [mL] / BSA [m]

Papillary muscles are often included in the blood volumes .

Interpretation

Normal values differ for the left and right ventricle depending on gender and age and with the imaging modality used :

MRI

Normal values are derived for 1.5 tesla from the publication by Kawel-Boehm :

Left ventricle:

Women (20-80 years):

• ESV:       22-66 mL
• ESVI:      14-34 mL/m

Men (20-80 years):

• ESV:      26-82 mL
• ESVI:     14-38 mL/m      

Values above the normal might indicate left ventricular systolic dysfunction.

Right ventricle:

Women (20-68 years):

• ESV:      24-84 mL
• ESVI:     12-52 mL/m

Men (20-68 years):

• ESV:      41-117 mL
• ESVI:     19-59 mL/m      

Values above the normal might indicate right ventricular systolic dysfunction.