The paradox of reduced myocardial shortening in the presence of preserved EF

The paradox of reduced myocardial shortening in the presence of preserved EF is explained mathematically through geometric factors, where EF can be constant for a large variation in shortening if other geometric factors are altered to compensate. Increased wall thickness and/or reduced ED volume augment EF, and therefore can maintain a normal EF despite reduced shortening. EF is quadratically dependent on circumferential shortening and only linearly dependent on longitudinal shortening; hence, EF is less sensitive to a reduction in longitudinal shortening. Our findings suggest that strain measurements reflect systolic function better than EF in patients with preserved EF.



Comparison Between Ejection Fraction and Strain


Editorial Comment V. Fuster MP4