The ejection fraction (EF) is an important measurement in determining how well your heart is pumping out blood and in diagnosing and tracking heart failure.
A significant proportion of patients with heart failure happen to have a normal ventricular ejection fraction at echocardiography during examination. Previously called diastolic heart failure, it is now referred to as heart failure with normal ejection fraction (HFNEF) or HF with preserved ejection fraction.
- Preserved ejection fraction (HFpEF) – also referred to as diastolic heart failure. The heart muscle contracts normally but the ventricles do not relax as they should during ventricular filling (or when the ventricles relax).
- Reduced ejection fraction (HFrEF) – also referred to as systolic heart failure. The heart muscle does not contract effectively and less oxygen-rich blood is pumped out to the body.
A measurement of how much blood the left ventricle pumps out with each contraction. Download our sheet: HF and Your Ejection Fraction Explained
What does it mean?
An ejection fraction of 60 percent means that 60 percent of the total amount of blood in the left ventricle is pushed out with each heartbeat.
- A normal heart's ejection fraction may be between 50 and 70.
- You can have a normal ejection fraction reading and still have heart failure (called HFpEF or heart failure with preserved ejection fraction). If the heart muscle has become so thick and stiff that the ventricle holds a smaller-than-usual volume of blood, it might still seem to pump out a normal percentage of the blood that enters it. In reality, though, the total amount of blood pumped isn't enough to meet your body's needs.
What's too low?
- A measurement under 40 may be evidence of heart failure or cardiomyopathy.
- An EF from 41 to 49 may be considered “borderline” but does not always indicate that a person is developing heart failure. It may indicate damage, perhaps from a previous heart attack.
- In severe cases, EF can be very low.
What's too high?
EF higher than 75 percent may indicate a heart condition like hypertrophic cardiomyopathy.
Tests for measuring EF (not all may be done):
- Echocardiogram (Echo) - most widely used test
- MUGA scan
- CAT scan
- Cardiac catheterization
- Nuclear stress test
Learn more about common tests for diagnosing heart failure
This content was last reviewed on 04/06/2015.