Which parameter is also a prognostic marker in HF besides LV dilation and LVESV?

• A. Right atrial pressure.
• B. Heart rate.
• C. LV wall thickness.
• D. Ejection fraction (EF).

Answer: (D)

In heart failure, how well the left ventricle can pump blood is a key predictor of outcomes. The ejection fraction measures the percentage of blood pumped out with each beat, giving a clear sense of systolic function. While LV dilation and LV end-systolic volume reflect structural remodeling, EF adds crucial information about the heart’s pumping efficiency. A lower EF indicates weaker contraction and is consistently associated with higher risk of death and HF hospitalizations, guiding prognosis and treatment decisions (distinguishing reduced vs preserved EF).

Right atrial pressure mainly reflects venous congestion and preload, and while it relates to severity, it isn’t as universally prognostic across all HF patients. Heart rate and LV wall thickness provide useful clinical context but don’t offer the same broad, established prognostic value as EF. Hence, the parameter that serves as a prognostic marker besides LV dilation and LVESV is the ejection fraction.