Key result
KDH metric offers a more powerful alternative to traditional EF by carrying physical units.
Why the study?
Traditional holosystolic EF and its alternatives are dimensionless ratios and therefore incomplete metrics for evaluating ventricular performance.
The proposed KDH metric offers a novel approach to evaluating ventricular performance by incorporating physical units, potentially overcoming limitations of traditional dimensionless ejection fraction metrics.
⅓EF may refine early systolic assessment in models; leaves open clinical validation and utility.
Ventricular performance is typically evaluated on the basis of primary measurements such as pressure, volume and flow. Representative recordings obtained from a healthy, chronically instrumented conscious dog can be employed to define various metrics, for example, the traditional holosystolic ejection fraction (EF). The metric EF is defined as 1 minus end-systolic volume (ESV) divided by end-diastolic volume (EDV). An alternative proposed 45 years ago refers to the first-third of EF (⅓EF), which is not (always) identical to first-phase EF1, launched several decades later. All these candidates refer to dimensionless ratios, and are therefore incomplete. Based on the early events during ejection time (ET), Kerkhof-Diaz-Handly (KDH) propose a more powerful metric which has the advantage of carrying physical units. The diastolic phase (TD) is the most variable portion of the cardiac cycle. ECG = electrocardiogram; LVD = left ventricular (equatorial) diameter; Paorta = ascending aorta pressure; Qaorta = ascending aorta flow.
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Kerkhof et al. (2026) studied Ventricular performance. Kerkhof-Diaz-Handly (KDH) metric vs. Traditional holosystolic ejection fraction (EF) was evaluated. The Kerkhof-Diaz-Handly (KDH) metric is proposed as a more powerful alternative to traditional dimensionless ejection fraction metrics because it carries physical units.
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