Ejection fraction

An ejection fraction (EF) is the volumetric fraction (or portion of the total) of fluid (usually blood) ejected from a chamber (usually the heart) with each contraction (or heartbeat). It can refer to the cardiac atrium,[1] ventricle,[2] gall bladder,[3] or leg veins,[4] although if unspecified it usually refers to the left ventricle of the heart. EF is widely used as a measure of the pumping efficiency of the heart and is used to classify heart failure types. It is also used as an indicator of the severity of heart failure, although it has recognized limitations.[5]

The EF of the left heart, known as the left ventricular ejection fraction (LVEF), is calculated by dividing the volume of blood pumped from the left ventricle per beat (stroke volume) by the volume of blood collected in the left ventricle at the end of diastolic filling (end-diastolic volume). LVEF is an indicator of the effectiveness of pumping into the systemic circulation. The EF of the right heart, or right ventricular ejection fraction (RVEF), is a measure of the efficiency of pumping into the pulmonary circulation. A heart which cannot pump sufficient blood to meet the body's requirements (i.e., heart failure) will often, but not invariably, have a reduced ventricular ejection fraction.[6]

Measurement

Ejection fraction is commonly measured by echocardiography,[7][8] although cardiac magnetic resonance imaging (MRI),[8][9] cardiac computed tomography,[8][9] ventriculography and nuclear medicine (gated SPECT and radionuclide angiography)[8][10] scans may also be used. Measurements by different modalities are not interchangeable.[11] Historically, the gold standard for measurement of the ejection fraction was ventriculography,[12] but cardiac MRI is now considered the best method.[13]

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