How important is assessment of LVEF by radionuclide techniques?

Overall, the LVEF is one of the most powerful predictors of future myocardial events and sudden death in patients with coronary artery disease. Its predictive value in coronary artery disease is probably related to global LV dysfunction manifested as the combination of poor myocardial perfusion and the presence of underlying scar tissue from previous myocardial infarctions, which is the substrate for future ischemic events or life-threatening cardiac arrhythmias.

LVEF is important in evaluating valvular heart disease, as baseline reduced LVEF suggests already-compromised LV function and is a poor prognostic sign when considering surgical intervention.

Exercise LVEF may be useful in the early detection of compromised LV systolic performance. When semi-erect or supine bicycle testing is used, the lack of increase in LVEF with exercise may predict loss of LV reserve, signaling the need for early intervention.

Both hypertrophic and dilated cardiomyopathy patients may benefit from diagnostic and prognostic information gained from determinations of LV systolic and diastolic performance. From idiopathic dilated cardiomyopathy to doxorubicin-induced cardiomyopathy, reduced LVEF is one of the greatest predictors of subsequent severe congestive heart failure and death.

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