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PubMed2026

Molecular Pathways, Target Landscape, and Translational Models in Heart Failure with Preserved Ejection Fraction.

Heart failure with preserved ejection fraction (HFpEF) is a substantial global health burden and the greatest unmet medical need for cardiovascular diseases. It is marked by pronounced clinical heterogeneity and complex multi-system pathophysiology with limited therapeutic options. Progress in developing effective therapeutics is constrained by the inadequacy of experimental models to fully recapitulate the multifactorial nature of the disease. Recent evidence underscores the significant involvement of inflammatory, oxidative, and mitochondrial pathways in the pathogenesis of HFpEF, with non-coding RNAs and epigenetic regulation serving as crucial modulators and prospective therapeutic targets. This review maps the HFpEF target landscape, while critically assessing the mechanistic contributions, translational fidelity, and limitations of existing in vivo and in vitro models. Further, advances are noted among the in vitro technologies, including human cardiac organoids and engineered heart tissues integrated with high-throughput multi-omics and computational modeling, enabling in-depth examination of HFpEF mechanisms. Finally, we underscore the necessity of integrative, systems-level approaches and multi-marker strategies to enhance translational relevance, improve risk stratification, and accelerate development of mechanism-based therapies. Collectively, this review supports phenotypic-guided and mechanism-informed therapeutic development for HFpEF, and provides a roadmap for next generation model development and therapeutic innovation.

Humans↗
PubMed2001

Dobutamine-induced augmentation of left ventricular ejection fraction predicts survival of heart failure patients with severe non-ischaemic cardiomyopathy.

AIMS: The prognosis of patients with severe non-ischaemic dilated cardiomyopathy is variable. The predictive value of currently utilized tests is suboptimal. The purpose of this study was to determine the prognostic value of dobutamine-induced augmentation of left ventricular ejection fraction in patients with non-ischaemic dilated cardiomyopathy. METHODS AND RESULTS: Sixty-two patients with left ventricular ejection fraction < or =0.30 underwent exercise testing with gas exchange analysis and assessment of left ventricular ejection fraction at rest and after a 10-min intravenous infusion of dobutamine at 10 microg x kg(-1) x min(-1), using equilibrium radionuclide ventriculography. Age was 48+/-11 years, 32% females, functional class 2.6+/-0.6, resting left ventricular ejection fraction 0.20+/-0.06, and peak exercise oxygen consumption (mVO2) 19+/-6 ml x kg(-1) x min(-1). Mean dobutamine-induced augmentation of left ventricular ejection fraction (DeltaLVEF) was 0.09+/-0.06 (median 0.08, range -0.03 to 0.26). Follow-up was 25+/-15 months during which there were 12 deaths and five transplantations. Patients were divided into two groups based on median DeltaLVEF. The transplant-free survival was better in the group with higher DeltaLVEF (94% vs 64%, P<0.008). In multivariate analysis incorporating age, gender, duration of chronic heart failure, functional class, right and left ventricular ejection fraction, DeltaLVEF, left ventricular end-diastolic volume index, and mVO2, only DeltaLVEF was predictive of 1-year, 3-year, and overall transplant-free survival (RR 0.09, 0.03, and 0.13;P 0.03, 0.09, and 0.08 respectively). The linear correlation between DeltaLVEF and mVO2(r=0.3) and between DeltaLVEF and left ventricular ejection fraction (r=0.5) was weak. CONCLUSION: Dobutamine-induced augmentation of left ventricular ejection fraction is a strong prognostic variable, independent of exercise capacity and resting ventriculographic variables, in severe non-ischaemic systolic dysfunctional heart failure.

Adult↗
PubMed1995

A comparison of clinical index and ejection fractions in predicting cardiac complications following infrarenal aortic reconstruction.

OBJECTIVE: To compare the Detsky clinical cardiac risk index with ejection fraction measurements in predicting postoperative cardiac events. DESIGN: Prospective study. SETTING: District General Hospital. MATERIALS: 48 patients undergoing infrarenal aortic reconstruction. CHIEF OUTCOME MEASURES: Ejection fractions were measured both by echocardiography and a technetium 99 MUGA scan. MAIN RESULTS: Three patients developed four major cardiac events (LVF three, fatal myocardial infarction one). Fourteen patients experienced 15 minor cardiac events (arrhythmia 11, ST segment depression four). The clinical index predicted postoperative cardiac problems (p = 0.0001). There was no correlation between ejection fraction measurement and postoperative cardiac events nor between ejection fraction measurements and the clinical index. Combining the index with ejection fraction measurement provided no additional information over the index alone. CONCLUSIONS: Calculation of a clinical index before aortic reconstruction is a simple and reliable way of selecting patients who are at risk of developing postoperative cardiac events.

Adult↗
PubMed1995

Prediction of right ventricular ejection fraction by Doppler determination of right systolic time intervals.

OBJECTIVES: This study was designed to evaluate the right ventricular function by means of the determination of right ventricular systolic time intervals measured in pulmonary artery flow detected by Doppler. BACKGROUND: Left ventricular systolic time intervals have been used to evaluate left ventricular performance. There is, however, no information as to whether right ventricular systolic time intervals may be useful in the evaluation of right ventricular function. METHODS: Simultaneous measurements of right ventricular ejection fraction and Doppler determination of right systolic time intervals were made in four pigs in 47 different hemodynamic conditions that permit the modification of the right ventricular ejection fraction from 15% to 68%. The preejection time, the ratio of right preejection time to right ventricular ejection time, with and without correction by the heart rate, were correlated simultaneously to invasively determined right ventricular ejection fraction and other hemodynamic parameters, measured with a modified pulmonary artery catheter with a rapidly responding thermistor. RESULTS: There was a significant linear correlation between Doppler determination of right systolic time intervals and right ventricular ejection fraction. A similar correlation was found for preejection time (r = .80, p < .0001) and the ratio of right preejection time to right ventricular ejection time with correction by the heart rate (r = .83, p < .0001). When we used a preejection time > 70 msec as a criterion to detect a ejection fraction < 40% we found a sensitivity of 89% and specificity of 88%. A preejection time > 80 msec, as criterion of more severe ventricular disfunction (ejection fraction < 30%), displayed a sensitivity of 76% and specificity of 100%. CONCLUSION: These results show that right ventricular systolic time intervals determined by Doppler study correlate significantly with the right ventricular ejection fraction. In view of its simplicity and its accuracy in the prediction of right ventricular ejection fraction, this method may provide useful non-invasive alternative in the prediction of right ventricular ejection fraction.

Animals↗
PubMed1983

Measurement of ejection fraction by thermal dilution techniques.

The reproducibility, accuracy, and clinical applicability of ventricular ejection fraction derived by a thermal dilution technique were assessed in 22 dogs and 18 patients. Results obtained by the thermal technique were compared to simultaneous results obtained by radionuclide angiography. Right ventricular ejection fraction, measured in 9 dogs (1014 determinations) and 8 patients (744 determinations) was reproducible +/- 5%. Left ventricular ejection fraction, measured in 10 patients, was reproducible +/- 5%. Correlation between thermal and radionuclear measurements varied from 0.86 to 0.93 (all P less than 0.02). We conclude that, because of its low cost, ease of use, and accuracy, thermally derived ejection fraction determinations can be helpful in hemodynamic monitoring of critically ill patients.

Angiography↗
PubMed1988

Densitometric regional ejection fraction: a new three-dimensional index of regional left ventricular function--comparison with geometric methods.

Densitometric regional ejection fraction obtained by computer analysis of digital subtraction ventriculography was evaluated as a new, quantitative, three-dimensional index of regional left ventricular performance. Eighteen patients with coronary artery disease and seven control subjects had right anterior oblique ventriculography at rest and immediately after rapid atrial pacing using central venous injection of contrast material. Regional left ventricular ejection fraction was determined by densitometry in six segments drawn around the end-diastolic center of gravity, and compared with two conventional indexes of segmental wall motion: area and radial regional ejection fraction. Densitometric, area or radial regional ejection fraction was classified as abnormal if it fell at least 2 standard deviations below the corresponding mean value in the normal group. The densitometric method did not require outlining of the end-systolic left ventricular silhouette and was the easiest and fastest to perform of all three techniques. In addition, intra- and interobserver reproducibilities were higher with the densitometric method (r = 0.97 and 0.95) than with either the area (r = 0.84 and 0.82) or the radial method (r = 0.82 and 0.76). Regional left ventricular dysfunction as assessed by the densitometric, area and radial techniques allowed the detection of coronary artery disease in 50, 50 and 44% of the patients at rest and in 83, 67 and 61% of the patients in the post-pacing period, respectively. Post-pacing regional left ventricular dysfunction accurately predicted the presence or absence of greater than 70% diameter stenosis in the supplying coronary artery in 75, 67 and 56% of the cases, respectively. Thus, densitometric analysis of digital subtraction ventriculography allows a fast and reproducible three-dimensional determination of regional left ventricular ejection fraction. Using this technique, pacing-induced regional dysfunction can be detected in most patients with coronary artery disease and corresponds well with the location of significant coronary artery lesions.

Absorptiometry, Photon↗
PubMed1979

Comparison of wall motion and regional ejection fraction at rest and during isometric exercise: concise communication.

The detection of regional abnormalities of left-ventricular wall motion provides strong evidence for the presence of coronary heart disease. In 129 patients undergoing coronary arteriography, the relative value of radionuclide angiographic assessment of wall motion was compared with computer-generated regional ejection fraction, at rest and during handgrip exercise. Wall motion was determined by superposition of computer-derived end-diastolic and end-systolic perimeters. Relative regional ejection fraction was determined using a computer-generated 16-color isocount image that permitted a quantitative assessment of zonal contribution to ejection fraction. Of the 129 patients, coronary arteries were normal in 31 and diseased in 98. Of 24 patients with single-vessel disease, wall-motion abnormalities were present, at rest or during exercise in 15, whereas regional ejection fraction detected 20 patients. Seventy-four patients had multivessel disease. Of these, wall-motion abnormalities occurred in 52 but regional ejection fraction was abnormal in 69 (p less than .01). Overall, sensitivity was 67% by wall motion and 91% by relative regional ejection fraction (p less than .001). Specificity was 94% by wall motion and 87% by regional ejection fraction (not significant). Thus, radionuclide angiographic assessment of regional ejection fraction during handgrip exercise is both highly sensitive and specific for coronary heart disease and significantly enhances detection of coronary heart disease compared with wall-motion assessment, with little loss in specificity.

Cardiac Output↗
PubMed1998

[Determination of ejection fraction and left ventricular fraction using isotopic ventriculography and bidimensional echocardiography. Comparison with contrast ventriculography].

OBJECTIVES: The aim of this study was to determine the correlation and agreement between the values of left ventricular ejection fraction and volumes assessed by echocardiography and radionuclide ventriculography with the results obtained by contrast angiography, as well as the variability of each method in these measurements. PATIENTS AND METHODS: In a group of 59 patients with a first acute myocardial infarction we have determined left ventricular ejection fraction and volumes by two-dimensional echocardiography, equilibrium radionuclide ventriculography and contrast angiography initially and six months after myocardial infarction. We also assess the variability in the determinations in these three methods. RESULTS: We found significant correlations in ejection fraction and volumes by radionuclide ventriculography and echocardiography with contrast angiography. The correlation was higher in ejection fraction and end-systolic volume by radionuclide ventriculography (r = 0.88 and r = 0.73) than by echocardiography (r = 0.55 and r = 0.63; p < 0.01), whereas the correlation of end-diastolic volume was moderate by both methods (r = 0.58 and r = 0.47), without significant differences. The agreement between contrast angiography and radionuclide ventriculography was higher, with narrower limits of agreement than between contrast angiography and echocardiography in ejection fraction as well as in ventricular volumes. We have found high and significant correlations between two determinations by each method in all parameters, although they were higher in ejection fraction by contrast angiography (r = 0.96) and radionuclide ventriculography (r = 0.98) than by echocardiography (r = 0.70; p < 0.01). The limits of agreement were always wider in echocardiography, narrower in contrast angiography and the narrowest in radionuclide ventriculography, showing its superior reproducibility. CONCLUSIONS: In this group of myocardial infarction patients, the variability in the measurements was lower by radionuclide ventriculography than by echocardiography, this could be the reason for overall better results found in correlation and agreement between radionuclide ventriculography and contrast angiography than between echocardiography and contrast angiography in the assessment of left ventricular ejection fraction and volumes.

Adult↗
PubMed1982

Hemodynamic correlates of right ventricular ejection fraction measured with gated radionuclide angiography.

Right ventricular function was studied in 60 patients with equilibrium gated radionuclide angiography. The mean (+/- standard deviation) right ventricular ejection fraction in 20 normal subjects was 53 +/- 6 percent, a value in agreement with previous data from both radionuclide and contrast angiographic studies. This value was similar (55 +/- 7 percent) in 11 patients with coronary artery disease but normal left ventricular function. Radionuclide measurements of right ventricular ejection fraction were correlated with right heart hemodynamics. There was a significant negative linear correlation between right ventricular ejection fraction and mean pulmonary arterial pressure (r = -0.82) and between right ventricular ejection fraction and right ventricular end-diastolic pressure (4 = -0.67). Furthermore, patients with elevated right ventricular end-diastolic pressure and mean pulmonary arterial pressure had a more severely depressed ejection fraction than did those with an elevated mean pulmonary arterial pressure alone. Thus, an abnormal value for right ventricular ejection fraction by gated radionuclide angiography in the absence of primary right ventricular volume overload suggests abnormal right heart pressures, whereas a normal value excludes severe pulmonary arterial hypertension or an elevated right ventricular end-diastolic pressure.

Adult↗
PubMed1988

Limitations in the interpretation of rest-exercise ejection fraction changes after early thrombolytic therapy during acute myocardial infarction.

The effect of exercise on left ventricular wall motion in the infarct and noninfarct regions, and their contribution to the global ejection fraction response to exercise was evaluated in 24 patients studied at least 2 weeks following thrombolytic therapy for acute myocardial infarction. To achieve this goal, a nonstandard protocol was used: contrast ventriculography was performed at rest and immediately following 3 minutes of supine bicycle exercise at 50 watts. Wall motion in the infarct and noninfarct regions was measured using the centerline method. The global ejection fraction response to exercise correlated poorly with the exercise response of motion in the infarct region (r = 0.38). In 15 of the 24 patients, the function of the infarct and noninfarct regions changed in opposing directions, and in only 8 (53%) of these did the global ejection fraction response follow the exercise response of motion in the infarct region. The motion of the noninfarct region was the predominant influence on the ejection fraction response in the other 7 patients. Subgroup analysis revealed that the global ejection fraction response was more dependent on the response of motion in the anterior wall (r = 0.71, p less than 0.001) than in the inferior wall (r = 0.16), regardless of infarct location. The regional wall motion response to exercise also better distinguished reperfused from nonreperfused patients than did the ejection fraction response. These results indicate that the global ejection fraction response to exercise may be an unreliable indicator of the functional status of the infarct region.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1980

Effect of age on the response of the left ventricular ejection fraction to exercise.

To assess the effects of age on the left ventricular ejection fraction (LVEF), we performed radionuclide angiocardiography at rest and during upright bicycle exercise in 77 healthy volunteers 20 to 95 years of age. Radionuclide measurements included left ventricular ejection fraction, end-diastolic volume, and regional wall motion. Age did not appear to influence any of these indexes at rest. However, during exercise the ejection fraction was less than 0.60 in 45 per cent of subjects over age 60 as compared with 2 per cent of younger subjects (P < 0.001). In addition, there was a decline in the change in LVEF (exercise LVEF minus rest LVEF) with increase in age (r = -0.71). Wall-motion abnormalities during exercise occurred with increasing frequency in patients who were 50 and older. In the older subjects these age-related changes in ejection fraction during exercise were not associated with differences in end-diastolic volume or blood pressure.

Adult↗
PubMed2006

The treatment of heart failure with preserved ejection fraction ("diastolic heart failure").

Unlike heart failure with a low ejection fraction, there is no evidence-based treatment for heart failure with preserved ejection fraction which improves clinical outcomes. Indeed, the only evidence for any treatment effect comes from small studies with verapamil where this drug increased exercise capacity and reduced a heart failure score. Large trials are presently underway which are examining the effect of treatment with an ACE inhibitor, ARB and aldosterone antagonist in patients with heart failure and preserved ejection fraction.

Adrenergic beta-Antagonists↗
PubMed2000

Accurate measures of left ventricular ejection fraction using electron beam tomography: a comparison with radionuclide angiography, and cine angiography.

BACKGROUND: Quantitative determination of ejection fraction is predicated on precise measurement of end-diastolic and end-systolic volumes of the left ventricle. Contrast enhanced electron beam tomography (EBT), with excellent temporal and spatial resolution, has the potential for highly accurate measures of ejection fraction. METHODS: EBT protocol used a short axis scan of the left ventricle (8-12 levels, apex to base) during infusion of iodinated contrast. To assess the accuracy of the measured left ventricular ejection fraction (LVEF), we compared EBT with first-pass radionuclide angiography (RNA) and cine angiography (CINE). RESULTS: A total of 41 patients (26 men and 15 women) underwent all three tests within 1 week. Resting ejection fraction using each modality was assessed in a linear regression model to assess inter-test correlation with the other two modalities. Correlation between CINE and EBT was high (r = 0.90, intercept 4.67, p < 0.001). Similarly, correlation of CINE and RNA (r = 0.87, intercept -5.48, p < 0.001) and between EBT and RNA (r = 0.87, intercept -4.6, p < 0.001) were high. In a subset of those patients with LVEF < or = 40%, correlation was consistently high between EBT and CINE. However, correlations were poor for the comparisons between RNA and CINE (r = 0.40), and between the RNA and EBT (r = 0.47). The mean differences of measured ejection fractions between each of the imaging modality were small. However, there was only modest agreement between each of the comparisons as measured using 95% confidence interval (CI) on Bland-Altman plots. CONCLUSION: These data indicate that the LVEF results are comparable among EBT, RNA, and CINE and can be used interchangeably to assess ventricular function for LVEF > 40%. For LVEF < or = 40%, we demonstrated some disparate results between cine angiography and RNA and between EBT and RNA, indicating that CINE or EBT may provide more accurate assessment.

Cineangiography↗
PubMed2006

Factors affecting accuracy of ventricular volume and ejection fraction measured by gated tl-201 myocardial perfusion single photon emission computed tomography.

The electrocardiogram-gated single photon emission computed tomography (SPECT) measurement of left ventricular end-diastolic volume, end-systolic volume and ejection fraction may contain substantial errors. We evaluated whether patient-related factors affect the accuracy of left ventricular volume and ejection fraction measured by gated Tl-201 SPECT. A total of 518 patients without perfusion defects on Tl-201 SPECT or coronary artery disease were studied. Left ventricular volume and ejection fraction were measured from echocardiography and adenosine stress/redistribution gated Tl-201 SPECT using commercially available software packages (QGS and 4D-MSPECT). We identified factors affecting the accuracy of gated SPECT via multiple linear regression analysis of the differences between echocardiography and gated SPECT. Gated SPECT analyzed with QGS underestimated end-diastolic and end-systolic volume, and overestimated ejection fraction, but 4D-MSPECT overestimated all those values (P<0.001). Independent variables associated with increasing the difference in end-diastolic volume between echocardiography and gated SPECT were decreasing left ventricular end-diastolic wall thickness, decreasing body surface area, female sex and increasing end-diastolic volume (P<0.001). Those for end-systolic volume were decreasing left ventricular end-systolic wall thickness, female sex, and decreasing end-systolic volume (P<0.001). Increasing end-systolic wall thickness, male sex and decreasing age were independent determinants associated with an increased difference in ejection fraction (P<0.001). Adenosine stress SPECT showed significantly higher end-diastolic and end-systolic volume values and a lower ejection fraction than did redistribution SPECT (P<0.001). Patient-related factors affect the accuracy of left ventricular volume and ejection fraction measured by gated Tl-201 SPECT. Modification of gated SPECT measurements by taking account of these factors would lead to reduce systemic errors.

Adenosine↗
PubMed1997

Measurement of right ventricular ejection fraction by contrast echocardiography.

We evaluated 20 healthy subjects with no cardiac disease (8 males, 12 females, age 49+/-12) to determine the accuracy of right ventricular ejection fraction measurement with contrast echocardiography performed with D-galactose (Echovist 300). All patients underwent two dimensional echocardiography where the right ventricular ejection fraction was calculated by the Simpson's rule first without contrast, then after the injection of 5 ml D-galactose in the same position and compared to the right ventricular ejection fraction measured by the first pass radionuclide angiography on the same day. Subjects had a normal left ventricular ejection fraction of 66+/-5 and a body mass index of 28.9+/-1.2. The correlation between echocardiographic and radionuclide derived right ventricular ejection fraction significantly increased when contrast was used (r=0.81 vs. r=0.6). The r value for interobserver variability also increased significantly with contrast use (r=0.98 vs. r=0.7). We conclude that D-galactose contrast injection significantly enhances border detection and improves the accuracy of right ventricular ejection fraction calculations with echocardiography making it a simple and reliable method.

Adult↗
PubMed1978

[Determination of cardiac output and ejection fraction using radionuclide angiography. A comparsion with conventional diagnostic methods in cardiology (author's transl)].

Cardiac output and ejection fraction of left and right ventricle were determined in 75 patients with different heart diseases applying a newly developed method which combines radionuclide angiography and triggered blood pool scintigraphy. The comparison of cardiac output and ejection fraction as determined by dye-dilution or thermodilution technique and left ventricular angiography is excellent (coefficient of correlation r equal to 0.86 and r equal to 0.91). Cardiac output and ejection fraction can be determined with this method in single non-invasive operation, i.e. under physiological conditions. The ejection fractions can be determined with high statistical accuracy from time-activity curves of both ventricles. Similar to cine-angiography it is possible to evaluate the ventricular volume, the regional contraction patterns and aneurysmata. Outpatients can be investigated in 30 min. Since the radiation dose in comparison to cine-angiography is very low, this investigation can be repeated several times without harm to the patient. There are no risks as described for cardiac catheterization and contrast angiography. Patients with low cardiac output and ejection fraction can be classified as "high risk patients". In these patients cardiac catheterization can be avoided by applying the described method.

Cardiac Output↗
PubMed1985

Effect of early postoperative volume loading on left ventricular systolic function (including left ventricular ejection fraction determined by myocardial marker) after myocardial revascularization.

The effects of early volume loading in terms of isovolumetric-phase and ejection-phase indexes of left ventricular systolic function were studied in 12 patients 5 hr after myocardial revascularization, with myocardial markers used to measure left ventricular volume directly and with simultaneous transmural left ventricular pressure measurements by micromanometers. Volume loading (increasing transmural left ventricular end-diastolic pressure from 11 +/- 4 to 15 +/- 5 mm Hg) induced a significant 14% increase in left ventricular end-diastolic volume index (LVEDVI), which was associated (as expected) with significant (p less than .005) augmentation of stroke work (+26%), left ventricular pressure-volume loop area (+35%), and stroke volume index (+22%) and with increments in left ventricular dP/dt and mean velocity of circumferential fiber shortening despite a simultaneous increase in left ventricular afterload. In contrast to previous radionuclide studies, however, left ventricular ejection fraction increased significantly (+9%) and the left ventricular end-systolic pressure-volume ratio did not fall. The relative change in ejection fraction was directly proportional to the increment in LVEDVI (r = .54, p = .03) and inversely related to the change in left ventricular end-systolic volume index (r = -.71, p = .0005). Patients who demonstrated a small or no increase in ejection fraction generally had a larger simultaneous increase in afterload, but one patient exhibited exhaustion of preload reserve. Ejection fraction, as an ejection-phase index of left ventricular performance, is highly dependent on afterload; therefore, interpretation of postoperative changes in ejection fraction must be undertaken only with strict caution.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Output↗
PubMed1985

Two-dimensional echocardiographic estimation of right ventricular area change and ejection fraction in infants with systemic right ventricle (transposition of the great arteries or hypoplastic left heart syndrome).

A reproducible, noninvasive method for estimating right ventricular (RV) function would greatly facilitate evaluation of infants in whom the RV supplies the systemic circulation. Therefore, 2-dimensional echocardiographically derived parameters, RV area-change fraction and RV ejection fraction (EF), were evaluated in 19 preoperative infants (age 1 to 30 days, mean 7 days), 12 with hypoplastic left heart syndrome and 7 with transposition of the great arteries. The area enclosed by the RV was measured in both a subxiphoid long-axis (coronal plane) and short-axis (parasagittal plane) view. From these measurements end-systolic and end-diastolic volumes were derived using Simpson's rule and the EF was calculated. The total area change fraction was calculated as the average of the long and the short-axis area change fraction. Similar measurements were made independently from biplane cineangiograms obtained within 3 days of the echocardiogram. The echocardiographically derived EF and area-change fraction were compared with the angiographic EF using linear regression analysis. The echocardiographic EF (mean 49 +/- 11) correlated well with the angiographic EF (mean 51 +/- 12, r = 0.84). The echocardiographic area-change fraction was somewhat less closely correlated with the angiographic EF (r = 0.79). Comparing short- and long-axis area-change fraction to echocardiographic EF, the short-axis measurements were better correlated than long-axis measurements (r = 0.86 and 0.75, respectively). (ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Output↗