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Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
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Evaluation of Left Ventricular Structure and Function using 3D Echocardiography

Published on: October 28, 2020

Comprehensive evaluation of the apex beat using 64-slice computed tomography: Impact of left ventricular mass and

Shoichi Ehara1, Takuhiro Okuyama, Nobuyuki Shirai

  • 1Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan. ehara@med.osaka-cu.ac.jp

Journal of Cardiology
|March 9, 2010
PubMed

Insights

Palpating the apex beat can help exclude patients with increased left ventricular (LV) mass. This bedside maneuver is a sensitive diagnostic tool for assessing cardiac conditions.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Clinical Examination

Background:

  • Physicians often palpate the apex beat to assess left ventricular (LV) size and hypertrophy.
  • The clinical significance of apex beat palpation remains unclear.
  • Multislice computed tomography (MSCT) allows detailed assessment of LV parameters and heart-to-chest wall distance.

Purpose of the Study:

  • To evaluate the relationship between apex beat characteristics (presence, location, impulse pattern) and LV function, volume, mass, and distance from the chest wall.
  • To determine the diagnostic value of apex beat palpation in identifying left ventricular hypertrophy.

Main Methods:

  • 200 consecutive patients undergoing MSCT angiography for coronary artery evaluation.
  • Apex beat palpation performed in supine and left lateral decubitus positions.
  • Multivariate analysis to identify independent factors associated with apex beat characteristics.

Main Results:

  • LV mass index, chest wall distance, and male sex were independently associated with the presence of apex beat in the supine position.
  • LV mass index correlated with apex beat location and impulse patterns (sustained or double).
  • Sustained or double apical impulse showed 57% sensitivity and 90% specificity for LV hypertrophy.

Conclusions:

  • Apex beat palpation is a sensitive method for ruling out increased LV mass.
  • This bedside maneuver has significant implications for clinical examination and cardiac assessment.
Abstract

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