# What is the ejection fraction?

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.

- Page: https://www.acalculator.org/health/ejection-fraction-calculator
- JSON spec: https://www.acalculator.org/health/ejection-fraction-calculator.json
- Version: 513da2c2a0cb

## Default answer

Example with the default inputs (End-diastolic volume (mL) 106, End-systolic volume (mL) 41, Sex Male): With an EDV of 106 mL and an ESV of 41 mL, the ejection fraction is 61%: Normal (52 to 72%).

## Inputs

| Key | Label | Description |
| --- | --- | --- |
| edv | End-diastolic volume (mL) | Left ventricular volume at the end of diastole (the fullest point), 10 to 1,000 mL. |
| esv | End-systolic volume (mL) | Left ventricular volume at the end of systole (the emptiest point), 1 to 1,000 mL. |
| sex | Sex | Sex at birth. The guideline gives different normal ranges for men and women. |

## Outputs

| Key | Label | Description |
| --- | --- | --- |
| ef | Ejection fraction | (EDV − ESV) ÷ EDV, as a whole percent. |
| grade | ASE/EACVI 2015 range | The Table 4 range of the shown ejection fraction for the sex. |
| sv | Stroke volume (mL) | EDV − ESV, to 1 decimal. |

## 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.

## Worked examples

1. edv = 106, esv = 41, sex = male gives 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).
2. edv = 76, esv = 28, sex = female gives 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).
3. edv = 100, esv = 48, sex = male gives ef = 52%, grade = Normal (52 to 72%), sv = 52. Source: Lang 2015, Table 4: 52% is the lowest normal EF for men.
4. edv = 100, esv = 48, sex = female gives ef = 52%, grade = Mildly abnormal (41 to 53%), sv = 52. Source: Lang 2015, Table 4: for women 41 to 53% is mildly abnormal.
5. edv = 200, esv = 130, sex = male gives ef = 35%, grade = Moderately abnormal (30 to 40%), sv = 70. Source: Lang 2015, Table 4: 70 ÷ 200 = 35%, moderately abnormal.
6. edv = 250, esv = 190, sex = female gives ef = 24%, grade = Severely abnormal (under 30%), sv = 60. Source: Lang 2015, Table 4: 60 ÷ 250 = 24%, severely abnormal.
7. edv = 200, esv = 97, sex = male gives ef = 52%, grade = Normal (52 to 72%), sv = 103.
8. edv = 100, esv = 25, sex = female gives ef = 75%, grade = Above the normal range (over 74%), sv = 75. Source: Lang 2015, Table 4: the normal range for women ends at 74%.

## FAQ

### What is the ejection fraction?

The share of the blood in the left ventricle that the heart pumps out with each beat. It is the stroke volume divided by the volume at the end of filling: EF = (EDV − ESV) ÷ EDV.

### How do I calculate the ejection fraction?

Subtract the end-systolic volume (ESV) from the end-diastolic volume (EDV) to get the stroke volume, then divide by the EDV. With the guideline’s mean volumes for men, 106 mL and 41 mL: (106 − 41) ÷ 106 = 0.613, or 61%.

### What is a normal ejection fraction?

The ASE/EACVI 2015 guideline gives a normal 2D echo range of 52 to 72% for men and 54 to 74% for women (Table 4). It says an EF under 52% in men or under 54% in women suggests abnormal pumping of the left ventricle.

### What do mildly, moderately, and severely abnormal mean?

They are the guideline’s grades below the normal range (Table 4): mildly abnormal 41 to 51% in men and 41 to 53% in women, moderately abnormal 30 to 40%, and severely abnormal under 30%. The guideline calls these partitions consensus values and says to read them with caution.

### Why do men and women have different ranges?

The ranges come from echo scans of healthy adults in seven databases. Women had a slightly higher mean EF (64%) than men (62%), and the guideline lists a range for each (Tables 2 and 4). Section 2.4 of the guideline also says EF is not significantly related to sex and calls 53 to 73% normal for adults over 20, while Table 4, which this page follows, grades by sex.

### Can I use volumes from a heart MRI or a nuclear scan?

The formula is the same, but the ranges on this page are Table 4 of the guideline, for 2D echocardiography by the biplane method of disks. The guideline lists 3D echo values separately (Table 3) and gives no ranges for MRI or nuclear scans. It no longer recommends EF from linear measurements (the Teichholz and Quinones methods).

### What is the stroke volume?

The volume pumped out in one beat: EDV − ESV. With 106 mL and 41 mL it is 65 mL. The cardiac output calculator on this site multiplies the stroke volume by the heart rate.

## 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)