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Assessment of left ventricular systolic function in research and in clinical practice
  1. Co-Director, Adult Echocardiography
  2. Department of Cardiology
  3. Greenlane Hospital
  4. Green Lane West, Auckland, New Zealand
  5. email:

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Left ventricular (LV) systolic function is a major prognostic factor in cardiac disease1-3; the serial reliable assessment of LV function is therefore essential. Since its development, echocardiography has played a major role in non-invasive evaluation.

M mode echocardiography

With the increasing sophistication of two dimensional echocardiography, it is notable that two groups with papers in this issue have used the very basic technique of M mode (one dimensional) echocardiography in the assessment of LV function. M mode measurements allow excellent resolution in measurement of LV diameters and wall thickness. Mahon and colleagues4 have taken advantage of this to identify LV enlargement in relatives of patients with dilated cardiomyopathy and then elegantly demonstrated metabolic abnormalities in these patients.

The population based heart failure study by Cowie and colleagues5 illustrates the limitations of M mode. It should be noted that echocardiography was not a primary focus of this study. Qualitative two dimensional and M mode echocardiographic findings were not significantly associated with outcome. In this heterogeneous group, M mode was likely inadequate for assessment of LV function. Data were missing in over 50% of patients, possibly because of the technical limitations of M mode.

M mode has shown little evolution until the relatively recent development of anatomic M mode,6 which allows independent positioning of M mode cursors on cine loops. This technique may have a role for patients …

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