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left ventricular ejection fraction (LVEF)

A measure of pumping action of the left ventricle (LV) of the heart. Indications: - assessment of heart failure - coronary artery disease - monitoring of cardiotoxicity during chemotherapy [1] Reference interval: - normal 65 +/- 8 %, 56-78%. Clinical significance: - lower values indicate ventricular dysfunction Principle: - LVEF is the difference between LV end diastolic volume & LV end systolic volume (stroke volume) divided by LV end diastolic volume (i.e. the % of blood emptied from the left ventricle through the aortic valve during systole) stroke volume / LV end diastolic volume Notes: - serial LVEF measurements best with 3D echocardiography - variability in different measurements ~6% [3] - lowest mortality with LVEF of 60-65% [4]

General

ejection fraction (EF)

References

  1. Thavendiranathan P et al. Reproducibility of echocardiographic techniques for sequential assessment of left ventricular ejection fraction and volumes: Application to patients undergoing cancer chemotherapy. J Am Coll Cardiol 2013 Jan 8; 61:77 PMID: 23199515 - Mor-Avi V and Lang RM. Is echocardiography reliable for monitoring the adverse cardiac effects of chemotherapy? J Am Coll Cardiol 2013 Jan 8; 61:85 PMID: 23199517
  2. Konstam MA, Abboud FM Ejection Fraction: Misunderstood and Overrated (Changing the Paradigm in Categorizing Heart Failure). Circulation. 2017;135(8):717-719 PMID: 28223323
  3. Pellikka PA, She L, Holly TA et al. Variability in ejection fraction measured by echocardiography, gated single-photon emission computed tomography, and cardiac magnetic resonance in patients with coronary artery disease and left ventricular dysfunction. JAMA Netw Open 2018 Aug 31; 1:e181456 Not indexed in PubMed https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2698631
  4. Wehner GJ, Jing L, Haggerty CM et al. Routinely reported ejection fraction and mortality in clinical practice: Where does the nadir of risk lie? Eur Heart J 2019 Aug 6; PMID: 31386109 https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehz550/5544337