{
  "id": "ejection-fraction",
  "version": "513da2c2a0cb",
  "status": "published",
  "name": "Ejection Fraction Calculator",
  "question": "What is the ejection fraction?",
  "summary": "Works out the left ventricular ejection fraction (LVEF) from the end-diastolic and end-systolic volumes, EF = (EDV − ESV) ÷ EDV, and grades it with the ASE/EACVI 2015 echo ranges for men and women.",
  "category": "health",
  "subcategory": "clinical",
  "url": "https://www.acalculator.org/health/ejection-fraction-calculator",
  "markdown": "https://www.acalculator.org/health/ejection-fraction-calculator.md",
  "kind": "function",
  "method": "EF = (EDV − ESV) ÷ EDV × 100%, rounded once to a whole percent (halves up); stroke volume = EDV − ESV. The shown EF is graded with Table 4 of the ASE/EACVI 2015 guideline for the sex.",
  "assumptions": [
    "The volumes come from 2D echocardiography by the biplane method of disks (modified Simpson’s rule), the method the guideline recommends.",
    "The ranges are those of Table 4 for 2D echo; the guideline calls its abnormal partitions consensus values, to be read with caution.",
    "The EF is worked from the exact typed volumes and rounded once to a whole percent, halves up; the range reads the shown value."
  ],
  "inputs": {
    "$schema": "https://json-schema.org/draft/2020-12/schema",
    "type": "object",
    "properties": {
      "edv": {
        "title": "End-diastolic volume (mL)",
        "description": "Left ventricular volume at the end of diastole (the fullest point), 10 to 1,000 mL.",
        "type": "number",
        "minimum": 10,
        "maximum": 1000
      },
      "esv": {
        "title": "End-systolic volume (mL)",
        "description": "Left ventricular volume at the end of systole (the emptiest point), 1 to 1,000 mL.",
        "type": "number",
        "minimum": 1,
        "maximum": 1000
      },
      "sex": {
        "title": "Sex",
        "description": "Sex at birth. The guideline gives different normal ranges for men and women.",
        "type": "string",
        "enum": [
          "male",
          "female"
        ]
      }
    }
  },
  "outputs": {
    "ef": {
      "label": "Ejection fraction",
      "description": "(EDV − ESV) ÷ EDV, as a whole percent.",
      "format": "percent"
    },
    "grade": {
      "label": "ASE/EACVI 2015 range",
      "description": "The Table 4 range of the shown ejection fraction for the sex.",
      "format": "text"
    },
    "sv": {
      "label": "Stroke volume (mL)",
      "description": "EDV − ESV, to 1 decimal.",
      "format": "number"
    }
  },
  "defaultAnswer": {
    "inputs": {
      "edv": 106,
      "esv": 41,
      "sex": "male"
    },
    "outputs": {
      "ef": 61,
      "grade": "Normal (52 to 72%)",
      "sv": 65
    },
    "text": "With an EDV of 106 mL and an ESV of 41 mL, the ejection fraction is 61%: Normal (52 to 72%)."
  },
  "examples": [
    {
      "given": {
        "edv": 106,
        "esv": 41,
        "sex": "male"
      },
      "expect": {
        "ef": 61,
        "grade": "Normal (52 to 72%)",
        "sv": 65
      },
      "source": "Lang 2015 (ASE/EACVI), Table 2 means for men (EDV 106 mL, ESV 41 mL): (106 − 41) ÷ 106 = 61.3%, normal 52 to 72% (Table 4) (hand calculation in content.mdx)"
    },
    {
      "given": {
        "edv": 76,
        "esv": 28,
        "sex": "female"
      },
      "expect": {
        "ef": 63,
        "grade": "Normal (54 to 74%)",
        "sv": 48
      },
      "source": "Lang 2015, Table 2 means for women (EDV 76 mL, ESV 28 mL): 48 ÷ 76 = 63.2%, normal 54 to 74% (Table 4) (hand calculation in content.mdx)"
    },
    {
      "given": {
        "edv": 100,
        "esv": 48,
        "sex": "male"
      },
      "expect": {
        "ef": 52,
        "grade": "Normal (52 to 72%)",
        "sv": 52
      },
      "source": "Lang 2015, Table 4: 52% is the lowest normal EF for men (hand calculation in content.mdx)"
    },
    {
      "given": {
        "edv": 100,
        "esv": 48,
        "sex": "female"
      },
      "expect": {
        "ef": 52,
        "grade": "Mildly abnormal (41 to 53%)",
        "sv": 52
      },
      "source": "Lang 2015, Table 4: for women 41 to 53% is mildly abnormal (hand calculation in content.mdx)"
    },
    {
      "given": {
        "edv": 200,
        "esv": 130,
        "sex": "male"
      },
      "expect": {
        "ef": 35,
        "grade": "Moderately abnormal (30 to 40%)",
        "sv": 70
      },
      "source": "Lang 2015, Table 4: 70 ÷ 200 = 35%, moderately abnormal (hand calculation in content.mdx)"
    },
    {
      "given": {
        "edv": 250,
        "esv": 190,
        "sex": "female"
      },
      "expect": {
        "ef": 24,
        "grade": "Severely abnormal (under 30%)",
        "sv": 60
      },
      "source": "Lang 2015, Table 4: 60 ÷ 250 = 24%, severely abnormal (hand calculation in content.mdx)"
    },
    {
      "given": {
        "edv": 200,
        "esv": 97,
        "sex": "male"
      },
      "expect": {
        "ef": 52,
        "grade": "Normal (52 to 72%)",
        "sv": 103
      },
      "source": "Rounded once to a whole percent, halves up, then graded (hand calculation in content.mdx)"
    },
    {
      "given": {
        "edv": 100,
        "esv": 25,
        "sex": "female"
      },
      "expect": {
        "ef": 75,
        "grade": "Above the normal range (over 74%)",
        "sv": 75
      },
      "source": "Lang 2015, Table 4: the normal range for women ends at 74% (hand calculation in content.mdx)"
    }
  ],
  "sources": [
    "Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015;16(3):233-271 (EF formula; biplane method of disks; Table 2, normal values by sex; Table 4, normal ranges and severity partition cut-offs for 2D echo LVEF). https://doi.org/10.1093/ehjci/jev014 (full text: https://academic.oup.com/ehjcimaging/article/16/3/233/2400086, retrieved 2026-10-18)"
  ],
  "related": [
    "cardiac-output"
  ],
  "changelog": [
    {
      "date": "2026-10-19",
      "note": "Published after this site's editorial review against the cited sources (no clinician review); the page notices say so."
    }
  ]
}