Cardiac output (CO) is product of the EF and the heart rate (HR):

The advantage of the modified Simpson's method over other volumetric methods listed in Table 5 is that it makes no assumptions about ventricular geometry. Nevertheless, considerable sonographer experience is required as images must be optimized and endocardial borders accurately identified and traced according to convention. Poor endocardial border definition, foreshortened views, and improper technique can compromise this technique.

LVEF shows high correlation, but less striking agreement, with radionuclide ventriculography and contrast cine-angiography. Even quantitative measures of LVEF can be inaccurate owing to limitations inherent in quantification formulae, as well as those of cardiac ultrasonography itself. Interobserver-variability remains a vexing issue in 2D echocardiography.

limitations of volumetric measures (ef) of lv systolic function

Overwhelming evidence from landmark clinical trials in heart failure and postmyocardial patients have demonstrated the proven value of LVEF assessment on patient management and prognosis. Nevertheless,

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