Formula to correct left ventricular ejection fraction in patients with mitral valve regurgitation

Abstract

Left ventricular ejection fraction is a key measurement for the assessment of systolic function. In case of mitral valve insufficiency, part of the ejected volume regurgitates to the left atrium, the anterograde volume is less than expected, and the ejection fraction maintains a value that does not adequately represent the inotropic state. This does not allow certain patients with heart failure to be correctly classified and treated, especially regarding the indication of devices (resynchronization therapy and defibrillator implant). Based on the calculation of the regurgitant fraction, we propose a simple formula to make a “correction” of the ejection fraction in this type of cases. The corrected ejection fraction was tested in a group of consecutive outpatients. The study confirmed that 54% of patients have their prognosis and/or treatment modified when applying the proposed formula.