Assessment of left ventricular function by echocardiography: a technique in evolution.

One of the earliest applications of clinical echocardiography was the evaluation of left ventricular (LV) size and function. The accuracy of the determination of global and regional LV function with echocardiography has improved as the technology has matured. The following paper discusses the advances in LV function assessment starting with Inge Edler's original A-mode and M-mode observation moving through two dimensional echocardiographic methods to new three dimensional echocardiographic assessment and even new Doppler and speckle myocardial methods. During the evolution of ultrasonic assessment of LV function, each new method has overcome limitations of previous ones, resulting in better appreciation of the LV geometry and volume and improved accuracy and reproducibility for quantitation. As discussed in this report, many of the echocardiographic methods used today to assess LV systolic function were envisioned by Harvey Feigenbaum more than 25 years ago. The future will undoubtedly see a new method of clinical cardiology care but with continued evolution, echocardiographic quantitation of LV function should remain a vital part of patient care.