Left Ventricular Ejection Fraction

Excerpt

Left ventricular ejection fraction (LVEF) is the central measure of left ventricular systolic function. LVEF is the fraction of chamber volume ejected in systole (stroke volume) in relation to the volume of the blood in the ventricle at the end of diastole (end-diastolic volume). Stroke volume (SV) is calculated as the difference between end-diastolic volume (EDV) and end-systolic volume (ESV). LVEF is calculated from:

LVEF: [SV/EDV] x 100

Normal ranges for two-dimensional echocardiography obtained LVEF as per the American Society of Echocardiography and the European Association of Cardiovascular Imaging are:

LVEF (%) among the male population:

1. 52% to 72% normal range

2. 41% to 51 mildly abnormal

3. 30% to 40% moderately abnormal

4. Less than 30% severely abnormal

LVEF (%) among the female population:

1. 54% to 74% normal range

2. 41% to 53 mildly abnormal

3. 30% to 40% moderately abnormal

4. Less than 30% severely abnormal

[SV: Stroke volume, EDV: End-diastolic volume]

The simplest classification as per the American College of Cardiology (ACC) that is used clinically as follows:

1. Hyperdynamic = LVEF greater than 70%

2. Normal = LVEF 50% to 70% (midpoint 60%)

3. Mild dysfunction = LVEF 40% to 49% (midpoint 45%)

4. Moderate dysfunction = LVEF 30% to 39% (midpoint 35%)

5. Severe dysfunction = LVEF less than 30%

Documentation may be quantitative (ejection fraction value) or qualitative (eg, "moderate dysfunction" or visually estimated ejection fraction).

Qualitative results should correspond to the numeric equivalents as above.