Left Ventricular Ejection Fraction (LVEF)

Introduction

Left ventricular ejection fraction (LVEF) is a key measurement in cardiology that reflects the heart's ability to pump blood. It is an essential indicator of heart function, particularly in diagnosing and managing heart failure and other cardiovascular diseases.

What is LVEF?

LVEF refers to the percentage of blood the left ventricle ejects with each contraction relative to the total amount of blood it contains. It is typically measured using echocardiography, cardiac MRI, or other imaging techniques.

Normal and Abnormal LVEF Ranges:

  • Normal: 55–70%
  • Mildly Reduced: 41–54%
  • Moderately Reduced: 30–40%
  • Severely Reduced: <30%

Causes of Reduced LVEF:

Several conditions can lead to a reduced ejection fraction, including: - Heart failure with reduced ejection fraction (HFrEF) - Coronary artery disease (CAD) and heart attacks - Hypertension (high blood pressure) - Cardiomyopathies (diseases of the heart muscle) - Valvular heart diseases

Why is LVEF Important?

A reduced ejection fraction can indicate weakened heart function and a higher risk of symptoms like shortness of breath, fatigue, and fluid retention. It also helps in making treatment decisions, such as the need for medications, implantable devices, or lifestyle modifications.

Treatment Strategies:

  • Medications: Beta-blockers, ACE inhibitors, ARNI, MRA, SGLT2 inhibitors
  • Lifestyle Changes: Low-sodium diet, regular exercise, smoking cessation
  • Devices: ICDs (implantable cardioverter defibrillators), CRT (cardiac resynchronization therapy)
  • Advanced Interventions: Heart transplant or LVAD in severe cases

Conclusion

LVEF is a crucial metric in heart health. Regular monitoring, adherence to a heart-healthy lifestyle, and medical management can significantly improve patient outcomes.

Source recommendations

1. American College of Cardiology/American Heart Association (ACC/AHA) Heart Failure Guidelines

  1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063
  2. https://www.acc.org/Guidelines
  3. https://www.jacc.org/doi/10.1016/j.jacc.2023.12.024
  4. https://www.acc.org/education-and-meetings/products-and-resources/features/global-cv-institute/heart-failure-guidelines
  5. https://pubmed.ncbi.nlm.nih.gov/35363499/

2. European Society of Cardiology (ESC) Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-and-Chronic-Heart-Failure
  2. https://pubmed.ncbi.nlm.nih.gov/34447992/
  3. https://academic.oup.com/eurheartj/article/42/36/3599/6358045
  4. https://pubmed.ncbi.nlm.nih.gov/22611136/
  5. https://academic.oup.com/eurheartj/article/44/37/3627/7246292

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