Utility and limitations of ejection fraction and of diastolic dysfunction in heart failure patients



  • Gian Francesco Mureddu | mureddu.gianfra@gmail.com San Giovanni-Addolorata Hospital, Department of Internal Medicine, Cardiac Rehabilitation and Secondary Cardiovascular Prevention Unit, Italy.
  • Andrea Faggiano University of Milan, Medical student, Italy.


The echocardiographic evaluation of left ventricular (LV) systolic function, and especially of ejection fraction (EF) plays a central role in the diagnosis of heart failure (HF) due to its undisputed prognostic value. Limitations of EF are substantially: i) the variability and reproducibility of measurements, and ii) the load-dependence. Measurement of stroke volume, longitudinal function and myocardial strain can overcome the limitations of EF in assessing the contractile reserve of patients with HF and may help to define both the phenotype and prognosis of the disease. The recognition of diastolic dysfunction (mainly by echocardiography) is the pathophysiological basis to make diagnosis of HF with preserved ejection fraction (HFpEF). The limitations are essentially related to its feasibility, since performing a multi-parametric quantitative echocardiographic evaluation, as indicated by the guidelines, may be difficult in clinical practice. Difficulties in method standardization, the poor attitude of cardiologists to test their reproducibility (test-retest, variability) favor the evaluation “at-a-glance†of LV structural and functional LV abnormalities.



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Cardiology - Reviews
Ejection fraction (EF), heart failure (HF), diastolic dysfunction, preserved EF, mid-range EF
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How to Cite
Mureddu, Gian Francesco, and Andrea Faggiano. 2019. “Utility and Limitations of Ejection Fraction and of Diastolic Dysfunction in Heart Failure Patients”. Monaldi Archives for Chest Disease 89 (1). https://doi.org/10.4081/monaldi.2019.1058.

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