Good question!

I think several aspects should be considered.

The last decades brought about many important placebo-controlled and other large trials that used LVEF as main inclusion or important stratification criterion. Take this as „heavy weight“.

Then, there is generally conservatism in medicine not too rapidly disregard “classical” variables to categorise a disease. This conservatism is sometimes good, sometimes not so good.

Then, often those new and highly sophisticated variables and scores touted by their inventors and supporters to more precisely predict an unwanted outcome of a disease were in fact often found to be no better than the traditional and simpler variables when investigated in large settings.

I read an article which might probably answer you

https://www.bsecho.org/evaluation-of-systolic-function-of-the-left-ventricle/

Dear Kruno,

you are completely right! There might be some parameters which are more sensitively as the EF is, but in clinical practice, the LV EF is the echocardiographic most easily parameter to measure. In hospital everyone of the collegues can determine the EF but only specialists can measure such complex parameters like the strain.

Best ragerds

Tanja

The global longitudinal strain (GLS) could be used to detect the early LV systolic dysfunction, for example in cancer patients who receive cardiotoxic chemotherapy. The changes in GLS occur earlier before the LVEF starts decreasing. In certain clinical situations, it can be a useful tool to detect early myocardial dysfunction. However, in clinical practice, LVEF remains the most widely used parameter to assess LV systolic function.