title: Echocardiographic assessment of left ventricular systolic function: from ejection fraction to torsion.
abstract: Assessment of left ventricular (LV) systolic function is the cornerstone of the echocardiographic examination. There are many echocardiographic parameters that can be used for clinical and research purposes, each one with its pros and cons. The LV ejection fraction is the most used one due to its feasibility and predictability, but it also has many limits, related to both the imaging technique used for calculation and to the definition itself. LV longitudinal function is expression of subendocardial fibers contraction. Because the subendocardium is often involved early in many pathological processes, its analysis has been a fertile field for the development of sensitive parameters. Longitudinal function can be evaluated in many ways, such as M-mode echocardiography, tissue Doppler imaging, and speckle tracking echocardiography. This latter is a relatively new tool to assess LV function through measurement of myocardial strain, with a high temporal and spatial resolution and a better inter- and intra-observer reproducibility compared to Doppler strain. It is angle independent, not affected by translation cardiac movements, and can assess simultaneously the entire myocardium along all the three-dimensional geometrical (longitudinal, circumferential, and radial) axes. Speckle tracking echocardiography also allows the analysis of LV torsion. The aim of this paper was to review the main echocardiographic parameters of LV systolic function and to describe its pros and cons.
authors.affiliation: Cardiology Department of Cardiovascular Diseases, University of Siena, Policlinico Le Scotte, Viale Bracci No 1, 53100, Siena, Italy. cameli@cheapnet.it.
authors.forename: Matteo
authors.initials: M
authors.lastname: Cameli
authors.affiliation: Cardiology Department of Cardiovascular Diseases, University of Siena, Policlinico Le Scotte, Viale Bracci No 1, 53100, Siena, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Mondillo
authors.affiliation: Cardiology Department of Cardiovascular Diseases, University of Siena, Policlinico Le Scotte, Viale Bracci No 1, 53100, Siena, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Solari
authors.affiliation: Cardiology Department of Cardiovascular Diseases, University of Siena, Policlinico Le Scotte, Viale Bracci No 1, 53100, Siena, Italy.
authors.forename: Francesca Maria
authors.initials: FM
authors.lastname: Righini
authors.affiliation: Cardiology Department of Cardiovascular Diseases, University of Siena, Policlinico Le Scotte, Viale Bracci No 1, 53100, Siena, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Andrei
authors.affiliation: Department of Clinical Medicine, Cardiovascular & Immunological Sciences, Federico II University School of Medicine, Naples, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Contaldi
authors.affiliation: Cardiology Department, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Eugenia
authors.initials: E
authors.lastname: De Marco
authors.affiliation: Department of Cardiology, University of L'Aquila, L'Aquila, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Di Mauro
authors.affiliation: Dipartimento di Scienze Biomediche Avanzate, Federico II University, Naples, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Esposito
authors.affiliation: Dipartimento di Scienze Biomediche Avanzate, Federico II University, Naples, Italy.
authors.forename: Sabina
authors.initials: S
authors.lastname: Gallina
authors.affiliation: Department of Cardiovascular and Neurological Science, University of Cagliari, Cagliari, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Montisci
authors.affiliation: Section of Cardiology, Department of Medicine, University of Verona, Verona, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rossi
authors.affiliation: Dipartimento di Scienze Biomediche Avanzate, Federico II University, Naples, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Galderisi
authors.affiliation: Cardiology Service, CMSR-Veneto Medica, Altavilla Vicentina, VI, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Nistri
authors.affiliation: Division of NonInvasive Cardiology, San Raffaele Hospital, Milan, Italy.
authors.forename: Eustachio
authors.initials: E
authors.lastname: Agricola
authors.affiliation: Cardiology Unit, University of Ferrara, Ferrara, Italy.
authors.forename: Donato
authors.initials: D
authors.lastname: Mele
mesh_terms: D001794:Blood Pressure; D004452:Echocardiography / Q000379:methods / Q000639:trends; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D015203:Reproducibility of Results; D013318:Stroke Volume; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: Ejection fraction; Speckle tracking; Strain; Stroke volume; Torsion