Treatment of secondary mitral regurgitation in patients with heart failure: when left ventricular ejection fraction may become not crucial

EuroIntervention 2021;17:e271-e273. DOI: 10.4244/EIJV17I4A48

Marco Metra
Marco Metra1, MD; Marianna Adamo1, MD
1. Cardiology and Cardiac Catheterization Laboratory, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
Left ventricular ejection fraction (LVEF) is the foundation of current classification for patients with heart failure (HF)1. It can be easily measured by echocardiography, has a close relation with outcomes and defines those patients with an indication to current evidence-based treatment for HF1,2,3.

However, many shortcomings of LVEF have been shown recently. Measurement of LVEF is operator-dependent with high inter- and intra-observer variability and is influenced by geometrical assumptions that make volume estimation inaccurate when based on two-dimensional images, such as with echocardiography. Second, the severity of the impairment in longitudinal and circumferential myocardial fibre layers may differ and ...

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