Abstract
Analysis of global and regional left ventricular (LV) function is the most frequent indication to perform echocardiography. While visual assessment based on 2D images is the basis for analysis of LV function, it may be supplemented by quantitative techniques to obtain parameters of global or regional function. 2D echocardiography tends to underestimate LV volumes compared to cardiac magnetic resonance (CMR), 3D echocardiography results in less volume underestimation and high accuracy in the analysis of ejection fraction. Visual analysis of regional function is limited by significant interobserver variability. Another approach to systolic LV function is the assessment of LV mechanics, typically by measuring global longitudinal deformation (strain) by speckle-tracking echocardiography. Alternatively, information on deformation can be obtained from CMR (currently, mostly by feature tracking). Deformation parameters detect early impairment of LV systolic function with higher sensitivity than ejection fraction. While echocardiography continues to be the first-choice modality for ejection fraction, CMR has become the gold standard for quantification of LV volumes and ejection fraction. Nuclear imaging should be applied to assess LV function only if simultaneous assessment of myocardial perfusion is requested.
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