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Pulmonary Hypertension

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Risk Stratification in PAH Pulmonary hypertension due to left heart disease Bosentan therapy in patients with Eisenmenger syndrome: a multicenter, double-blind, randomized, placebo-controlled study Challenges and Special Aspects of Pulmonary Hypertension in Middle- to Low-Income Regions: JACC State-of-the-Art Review Evidence-based detection of pulmonary arterial hypertension in systemic sclerosis: the DETECT study Pulmonary Hypertension Caused by a Coconut Left Atrium The association between body mass index and obesity with survival in pulmonary arterial hypertension Genetic analyses in a cohort of 191 pulmonary arterial hypertension patients Levosimendan Improves Hemodynamics and Exercise Tolerance in PH-HFpEF: Results of the Randomized Placebo-Controlled HELP Trial Refined balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension

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.