What is the ejection fraction?

Medical disclaimer

This calculator is for information and education only. It is not medical advice, and its result is not a diagnosis. Do not use it to start, stop, or change a treatment without a clinician who knows your health history. No licensed clinician has reviewed this page. This site's editors checked the formulas and worked examples against published sources. If you think you have a medical emergency, call your local emergency number.

When this does not apply. The ranges are for adults, from 2D echocardiography of the left ventricle by the biplane method of disks (Lang 2015, Table 4). They come from healthy adults in seven databases; people with a systolic pressure over 140 mmHg, a diastolic pressure over 80 mmHg, treated high blood pressure, diabetes or a raised fasting glucose, a BMI over 30, or abnormal kidney or lipid values were left out. The guideline calls its abnormal grades consensus values to be read with caution. The ranges are not for children, for the right ventricle, for EF from linear measurements, or for EF from 3D echo, MRI, or nuclear scans. Volumes outside 10 to 1,000 mL (EDV) or 1 to 1,000 mL (ESV), or an ESV that is not below the EDV, give no answer.

How it works

With the left ventricular end-diastolic volume EDV and end-systolic volume ESV, in mL:

• stroke volume SV = EDV − ESV;
• ejection fraction EF = (EDV − ESV) ÷ EDV × 100%.

The page works with the exact typed decimals. It rounds the EF once to a whole percent, halves up, and the stroke volume once to 1 decimal. The rounded EF is the result, and the range reads it. The ranges are Table 4 of Lang 2015 (2D echo):

Table 4 stops at the top of the normal range; the page calls a higher EF "above the normal range" and gives it no grade.

So EDV 200 mL and ESV 97 mL give 103 ÷ 200 = 51.5%, shown as 52%, which is normal for a man and mildly abnormal for a woman.

Allowed input. EDV 10 to 1,000 mL, ESV 1 to 1,000 mL. An ESV equal to or above the EDV gives no answer.

Assumptions

• The volumes are from one 2D echo study by the biplane method of disks (modified Simpson’s rule).
• The result is for education. It is not medical advice.

Worked examples by hand

Page default, the Table 2 means for men. EDV 106 mL, ESV 41 mL. SV = 65 mL. EF = 65 ÷ 106 = 61.32%, shown as 61%: normal (52 to 72%).

The Table 2 means for women. EDV 76 mL, ESV 28 mL. SV = 48 mL. EF = 48 ÷ 76 = 63.16%, shown as 63%: normal (54 to 74%).

52%, man and woman. EDV 100 mL, ESV 48 mL. EF = 52 ÷ 100 = 52%: normal for a man, mildly abnormal (41 to 53%) for a woman.

Moderately abnormal. EDV 200 mL, ESV 130 mL. SV = 70 mL. EF = 70 ÷ 200 = 35%.

Severely abnormal. EDV 250 mL, ESV 190 mL, a woman. SV = 60 mL. EF = 60 ÷ 250 = 24%.

Rounding. EDV 200 mL, ESV 97 mL, a man. EF = 103 ÷ 200 = 51.5%, shown as 52% (halves up): normal.

Above the normal range. EDV 100 mL, ESV 25 mL, a woman. EF = 75 ÷ 100 = 75%: above the normal range (over 74%).