When there is __________ you cannot use fractional shortening

When there is __________ you cannot use fractional shortening

• A. Hypertrophy
• B. Regional wall motion abnormalities
• C. Valvular regurgitation
• D. Atrial fibrillation

Answer: (B)

Regional wall motion abnormalities disrupt the idea that the left ventricle contracts uniformly, which is needed for fractional shortening to reflect global systolic function. Fractional shortening uses the change in the LV internal dimension from diastole to systole, measured along a single plane, and assumes the entire ventricle shortens in sync. When parts of the wall are akinetic or hypokinetic, that single-dimension measurement no longer represents how much blood the ventricle ejects overall, so the FS value becomes unreliable as a global function index. In these cases, use volumetric assessments that account for the whole LV, such as ejection fraction by Simpson’s method or 3D/volume measurements. Hypertrophy, valvular regurgitation, and atrial fibrillation do not inherently prevent FS: geometry changes from hypertrophy can still allow FS to be measured (though interpretation may be affected), regurgitation doesn’t automatically invalidate the measurement, and atrial fibrillation requires averaging over multiple cycles due to rhythm irregularity but FS can still be obtained.

Regional wall motion abnormalities disrupt the idea that the left ventricle contracts uniformly, which is needed for fractional shortening to reflect global systolic function. Fractional shortening uses the change in the LV internal dimension from diastole to systole, measured along a single plane, and assumes the entire ventricle shortens in sync. When parts of the wall are akinetic or hypokinetic, that single-dimension measurement no longer represents how much blood the ventricle ejects overall, so the FS value becomes unreliable as a global function index. In these cases, use volumetric assessments that account for the whole LV, such as ejection fraction by Simpson’s method or 3D/volume measurements.

Hypertrophy, valvular regurgitation, and atrial fibrillation do not inherently prevent FS: geometry changes from hypertrophy can still allow FS to be measured (though interpretation may be affected), regurgitation doesn’t automatically invalidate the measurement, and atrial fibrillation requires averaging over multiple cycles due to rhythm irregularity but FS can still be obtained.