2016
DOI: 10.1002/ajum.12007
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Ejection fraction - A number to be interpreted with caution!

Abstract: Cardiogenic shock is frequently seen following acute myocardial infarction complicated by the rupture of interventricular septum and formation of functional ventricular septal defect. Despite significant advances in medical, interventional and surgical management, the mortality in this group of patients remains very high. We present a case of refractory cardiogenic shock following an exclusion bovine pericardial patch repair of post infarction ventricular septal defect, where the residual functional left ventr… Show more

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Cited by 3 publications
(3 citation statements)
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“…It is a traditional reference value in cardiology, as well as a validated prognostic value in many historic studies. However, in the critically ill, particularly in those with shock, it should be used with caution [ 16 , 17 ]. LV EF is greatly influenced by mitral regurgitation, LV geometry and loading conditions [ 18 , 19 ].…”
Section: Left Ventricular Ejection Fraction—a Precarious Measurementmentioning
confidence: 99%
See 1 more Smart Citation
“…It is a traditional reference value in cardiology, as well as a validated prognostic value in many historic studies. However, in the critically ill, particularly in those with shock, it should be used with caution [ 16 , 17 ]. LV EF is greatly influenced by mitral regurgitation, LV geometry and loading conditions [ 18 , 19 ].…”
Section: Left Ventricular Ejection Fraction—a Precarious Measurementmentioning
confidence: 99%
“…If the LV cavity is anatomically small, the LV EF can be misleadingly raised. In these scenarios indexed SV assessments may better reflect haemodynamic status [ 16 ] and systolic function can be described by S’ using tissue Doppler imaging (TDI), which is suggested to be less load dependent [ 20 ]. In addition, low EF does not necessarily mean low SV and low CO, as can be observed in patients with large end-diastolic LV volume and patients with tachycardia, respectively.…”
Section: Left Ventricular Ejection Fraction—a Precarious Measurementmentioning
confidence: 99%
“…As a result of that, its usefulness is limited in critically ill patients [2]. Hence, in severe shock states, the estimation of CO, measured as a calculation of stroke volume (SV) times the heart rate, is a more reliable quantitative parameter as it truly reflects circulatory status and organ perfusion [9]. In the standard method, SV is determined by the LVOT area (obtained by measuring the LVOT diameter in parasternal long-axis view in mid-systole), multiplied by the LVOT Velocity Time Integral (VTI)-which is the distance the blood travels across the LVOT-calculated after tracing the LVOT pulsed-wave doppler (PWD) spectral display (Figure 1).…”
Section: Echocardiographic Variablesmentioning
confidence: 99%