Heart 99:1078-1086 doi:10.1136/heartjnl-2012-303433
  • Review

Methods used for the assessment of LV systolic function: common currency or tower of Babel?

  1. Thomas H Marwick
  1. Correspondence to Dr Thomas H Marwick, Menzies Research Institute Tasmania, 17 Liverpool St, Hobart T7000, Australia; tom.marwick{at}
  • Received 7 September 2012
  • Revised 27 November 2012
  • Accepted 8 January 2013
  • Published Online First 2 February 2013


The last decade has produced a proliferation of techniques for the assessment of left ventricular systolic function, and there now seems to be more choice than seems rational for the questions that we need answers to. In some instances, simple estimation is all that is required—the risk stratification process is inexact, as emphasised by the variety of modalities used to characterise ejection fraction (EF) in studies that validated the efficacy of treatments selected on the basis of EF. Nonetheless, while technical advances often cause disruption and confusion, it would be wrong to dismiss them as lacking benefit. The purpose of this review is to try to provide rational grounds for selecting both test modality and physiological parameter in various specific clinical situations.

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