Modalities for Detection of LV Dysfunction
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The left ventricular ejection fraction (LVEF) assessed by trans-thoracic Echocardiogram (TTE) remains the most common parameter of LV performance that is used in clinical practice. Three-dimensional / volumetric methods are more accurate, but are cumbersome to be performed in every case. The measures of myocardial contractility are more sensitive, reliable and with lesser inter observer variability but their place in daily practice is limited. Two-dimensional echocardiogram has the advantages of easy availability, low cost, portability, lack of radiation and non-invasive nature. Radionuclide studies, SPECT, cardiac CT and cardiac MRI are available only in a few centers and have more specific indication to be performed. The choice of a modality depends on the information sought by the clinician and the availability of expertise. Additional cost, radiation and limited access are important limitations of these special imaging modalities. The invasive methods which were popular a few decades back are by and large relegated to academic exercise.