Use of the Left Ventricular Internal Dimension at End-Diastole and the E-Point Septal Separation Ratio in the Prediction of the Left Ventricular Systolic Function in Patients with Midrange and Reduced Ejection Fractions: A Pilot Study

Background: the aim of this study was to investigate the ability of a new index, namely the left ventricular internal dimension at end-diastole/mitral valve e-point septal separation (lvidd/epss), to predict the left ventricular (lv) systolic function and to compare its performance with that of the epss index and to investigate the correlation between the lvidd/epss and the left ventricular ejection fraction (lvef). methods: the current study recruited 142 patients who presented to the cardiology clinic of sakarya university education and research hospital and were followed for heart failure (hf).m-mode measurements of the epss and the lvidd were recorded in the parasternal long-axis view. results: totally, 142 hf patients with midrange ejection fraction (hfmref) and reduced ejection fraction (hfref) were enrolled in the study. there was a significantly correlation both between the ef and the epss and between the ef and the lvidd/epss (p<0.001). in both hfmref and hfref groups, the correlation between the lvidd/epss and the ef was more significant than was the correlation between the epss and the ef (p<0.001). the results of the linear regression analysis indicated that the lvidd/epss was an independent predictor of the hfmref and the hfref (p<0.001). in the patients with epss≤12, there was a significant association between the ef and the lvidd/epss (p<0.001) but not between the ef and the epss(p>0.05). the receiver operating characteristic curve analysis showed that the lvidd/epss predicted advanced hf with 87% sensitivity and 72% specificity, using a cutoff value of 3.35,and it predicted the hfref (ef<40%) with 84% sensitivity and 81% specificity, using a cutoff value of 3.75. conclusion: the lvidd/epss may allow certain clinicians, especially beginners and emergency department physicians, to assess the lvef when other methods are not available or questionable.