Validity of ejection fraction as a measure of myocardial functional state: impact of asynchrony

Validity of ejection fraction as a measure of myocardial functional state: impact of asynchrony

Aims The goal of this study was to test whether peculiarities of left ventricular (LV) regional function place limits on the validity of ejection fraction (EF) as a measure of the myocardial functional state. Methods and results Transthoracic and transoesophageal data from patients with a variety of...

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Bibliographic Details
Published in:European journal of echocardiography Vol. 10; no. 5; pp. 613 - 618
Main Authors: Blyakhman, Felix A., Naidich, Anna M., Kolchanova, Svetlana G., Sokolov, Sergey Yu, Kremleva, Yulia V., Chestukhin, Vasily V.
Format: Journal Article
Language:English
Published: England Oxford University Press 01-07-2009
Subjects:
Echocardiography
Echocardiography, Three-Dimensional
Echocardiography, Transesophageal
Humans
Image Processing, Computer-Assisted
Myocardial Contraction
Reproducibility of Results
Stroke Volume - physiology
Ventricular Dysfunction, Left - diagnostic imaging
Ventricular Dysfunction, Left - physiopathology
Regional wall motion
Ultrasound examination
3D reconstruction
Left ventricle
Ejection fraction
Mechanical asynchrony
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Summary:Aims The goal of this study was to test whether peculiarities of left ventricular (LV) regional function place limits on the validity of ejection fraction (EF) as a measure of the myocardial functional state. Methods and results Transthoracic and transoesophageal data from patients with a variety of cardiac conditions were used for analysis of LV regional function. The focus was on the effects of mechanical asynchrony. Ejection fraction was calculated on the basis of LV end-diastolic volume and end-systolic volume obtained by two different ways: (i) end-systolic volume as a whole; and (ii) the sum of all regional end-systolic volumes (which may occur at different times). The relative difference, D-EF, between EFs obtained by (i) and (ii) was taken as the 'merit' of EF. A value of zero is the highest merit. Irrespective of the examination method, we found that D-EF was always higher than zero, and that its value depended on the extent of mechanical asynchrony. Conclusions Ejection fraction is not the arithmetic average of regional EFs. An increase of asynchrony increases D-EF, i.e. it reduces the merit of EF as a measure of cardiac function.
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ISSN:1525-2167
1532-2114
DOI:10.1093/ejechocard/jep010