Which test best estimates left ventricular systolic function in routine practice?

• A. CT angiography
• B. Echocardiography
• C. Nuclear perfusion scan
• D. Cardiac MRI

Answer: (B)

Estimating how well the left ventricle pumps relies on an imaging test that can visualize the heart in motion and quantify the amount of blood ejected with each beat. Echocardiography uses ultrasound to image the heart in real time, measure LV volumes, and calculate ejection fraction with methods like the Simpson biplane. It also reveals regional wall motion, which helps gauge overall systolic function and detect areas of poor contraction. Its combination of real-time evaluation, ability to quantify function, and broad availability makes it the go-to test in routine practice.

While other tests have strong roles in cardiology, echo stands out for this purpose in everyday care. Cardiac MRI can be more precise for volumes and EF but is less accessible and costlier. Nuclear perfusion imaging provides functional information but involves radiation and is typically used for ischemia assessment rather than routine function monitoring. CT angiography mainly assesses coronary anatomy and is not the primary tool for estimating LV systolic function.