Are Clinical Heart Failure and Ejection Fraction Always Connected?

摘要

Left Ventricular Ejection Fraction % (LVEF%) is an hemodynamic index indicative for left ventricular function.Its numeric value can be obtained by different methods, such as two- or three-dimensional echocardiography, cardiaccatheterization, and Nuclear Medicine-methods. It depends not only on myocardial contractility but also on preload andafterload, as well as heart rate and left ventricular distensibility.Normal LVEF% is recorded in patients with diastolic heart failure. On the contrary, in patients with systolic heart failure,values of LVEF% <40% usually are found. That generally is connected with clinical symptoms of congestive failure.Nevetheless, a mismatch between low LVEF% and congestive signs can be evident in some forms of systolic HF. Thatmay happen in patients with slowly progressive reduction of systolic left ventricular function. In this occurrence, determiningfactors of LVEF% can mutually balance each other, through in presence of reduction of one or more determinants.In addition, in some valvular cardiac incompetences, as aortic and mitral insufficiency or in congenital heart disease, suchas intra-ventricular and intra-atrial defects, LVEF% can be preserved, also in presence of signs of inadequate peripheralperfusion. Conclusively, LVEF% is an useful hemodynamic parameter, that is not always indicative of left ventricularfunction concerning the peripheral perfusion.