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Advances in therapeutic interventions for patients with pulmonary arterial hypertension Identifying At-Risk Patients with Combined Pre- and Postcapillary Pulmonary Hypertension Using Interventricular Septal Angle at Cardiac MRI Medical Therapy for CTEPH: Is There Still Space for More? Haemodynamic definitions and updated clinical classification of pulmonary hypertension Immunotherapy of Endothelin-1 Receptor Type A for Pulmonary Arterial Hypertension Circulating Plasma microRNAs In Systemic Sclerosis-Associated Pulmonary Arterial Hypertension Microvascular disease in chronic thromboembolic pulmonary hypertension: a role for pulmonary veins and systemic vasculature Update on chronic thromboembolic pulmonary hypertension Pulmonary artery denervation for treatment of a patient with pulmonary hypertension secondary to left heart disease Pulmonary artery denervation to treat pulmonary arterial hypertension: the single-center, prospective, first-in-man PADN-1 study (first-in-man pulmonary artery denervation for treatment of pulmonary artery hypertension)
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Review ArticleVolume 72, Issue 19, November 2018

JOURNAL：J Am Coll Cardiol. Article Link

Ejection Fraction Pros and Cons: JACC State-of-the-Art Review

TH Marwick Keywords: ejection fraction; heart failure; myocardial infarction; strain; valvular heart disease

ABSTRACT

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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