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Left ventricular (LV) ejection fraction (LVEF) is a simple measure of global systolic function that pervades the risk evaluation and management of many cardiovascular diseases. However, this parameter is limited not only by technical challenges, but also by pathophysiological entities where the ratio of stroke volume to LV cavity size is preserved.
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Echocardiography is readily available, safe and relatively cheap, but is operator-dependent. Improved ultrasound technology and use of harmonic imaging have improved detection of apical LVT. The sensitivity of echocardiography can be further improved by the use of ultrasound contrast agents. 27
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