Left ventricular ejection fraction: time to revise the metric?

Author:

Ray Avik12ORCID,Zlotoff Dan3,Kawachi Ichiro4

Affiliation:

1. Division of Pharmacoepidemiology and Pharmacoeconomics , Department of Medicine, , Boston, MA 02120 , United States

2. Brigham and Women’s Hospital , Department of Medicine, , Boston, MA 02120 , United States

3. Department of Medicine, Massachusetts General Hospital , Boston, MA 02114 , United States

4. Department of Social and Behavioral Sciences , Harvard T.H. Chan School of Public Health, Boston, MA 02115 , United States

Abstract

Abstract In this paper, we highlight the prevalent misconception among patients regarding the normal value of left ventricular ejection fraction in cardiac function assessment. This misconception arises from the proportion dominance effect, wherein individuals tend to judge based on proportions rather than absolute values. We explain how this misunderstanding impacts patient demoralization and medical adherence, leading to worse clinical outcomes. To address this, the concept of “Left Ventricular Ejection Fraction - Proportion of Normal” is introduced, which adjusts left ventricular ejection fraction to a patient-specific normal range. This patient-centric approach aims to enhance comprehension, engagement, and adherence by conveying accurate information through the lens of proportions, thereby potentially improving clinical outcomes.

Publisher

Oxford University Press (OUP)

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