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Among them, D-shaped LV is one of echocardiographic parameters suggesting the presence of elevated RV pressure. An abnormal pressure gradient between LV and RV can lead to D-shaped LV. This can be calculated using the eccentricity index and is primarily used to separate patients with RV pressure from those with volume .D-shaped left ventricle evidenced during systole (particularly end-systole) suggests RV pressure overload, whereas a D-shaped ventricle in diastole suggests RV volume overload. Septal flattening is best appreciated in the short-axis view at the level of the basal or mid-left ventricle.
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