Author + information
- Received May 21, 2018
- Revision received August 6, 2018
- Accepted August 9, 2018
- Published online October 29, 2018.
- ↵∗Address for correspondence:
Dr. Thomas H. Marwick, Baker Heart and Diabetes Institute, Melbourne, PO Box 6492, Melbourne, Victoria 3004, Australia.
Ejection fraction (EF) reflects both cardiac function and remodeling, and is widely recognized as a valuable diagnostic and prognostic tool. Its use in a variety of settings, ranging from heart failure and myocardial infarction to valvular heart disease, has made it a cornerstone of modern cardiology, pervading guidelines and practice. However, the development of the test was in another era, with younger patients and a lower prevalence of heart failure with preserved EF. The performance expectations of EF in the current era are also demanding—in relation to detection of subclinical LV dysfunction, and especially relating to recognition of changes in LV function on sequential testing—for example in patients taking cardiotoxic drugs. This review discusses whether the impressive evidence base for EF justifies its ongoing use in the context of newer markers of LV function, and the sophisticated questions posed by modern cardiology.
Dr. Marwick has received research support from General Electric Medical Systems.
- Received May 21, 2018.
- Revision received August 6, 2018.
- Accepted August 9, 2018.
- 2018 American College of Cardiology Foundation
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