Key result
EF remains a cornerstone but trails newer markers in detecting subclinical dysfunction and sequential changes.
Why the study?
EF was developed in an earlier era, raising questions about whether its evidence base justifies ongoing use given demanding modern performance expectations and newer markers of LV function.
This review highlights the limitations of traditional ejection fraction measurement in modern cardiology and questions its ongoing dominance compared to newer markers of left ventricular function.
EF thresholds from prior eras may misclassify today's HFpEF-dominant patients; leaves open whether refined metrics should update guidelines.
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.
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Thomas H. Marwick (2018) conducted a review in Left ventricular dysfunction. Ejection fraction vs. Newer markers of LV function was evaluated. Ejection fraction remains a cornerstone of cardiology, though its historical development poses challenges for detecting subclinical dysfunction and sequential changes compared to newer markers.
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