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Editor's Note
March 17, 2021

Is the Left Ventricular Ejection Fraction Measurement Still Preeminent?—New Measures to Quantify Subclinical Systolic Dysfunction

Author Affiliations
  • 1Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
  • 2Deputy Editor, JAMA Cardiology
  • 3Ahmanson-UCLA Cardiomyopathy Center, David Geffen School of Medicine, University of California, Los Angeles
  • 4Section Editor, JAMA Cardiology
JAMA Cardiol. 2021;6(5):521. doi:10.1001/jamacardio.2021.0143

In 1628, William Harvey1 assumed that the heart emptied completely in systole. In 1888, Roy and Adami2 confirmed that a residual volume remained in the heart. In 1906, Henderson3 estimated the normal ejection of blood from the heart with each beat to be approximately two-thirds. This principle is sacrosanct and describes normal left ventricular (LV) systolic function. It was Folse and Braunwald4 in 1962 who observed “estimations of the fraction of the left ventricular end-diastolic volume that is ejected into the aorta during each cycle…provide information that is fundamental to a hemodynamic analysis of left ventricular function.”4(p 684) This history of the assessment of ventricular function and origin of the ejection fraction is necessary because it establishes the primacy of this assessment of LV ejection fraction (LVEF). The question, however, is whether it remains preeminent.

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