Ejection Fraction

And life expectancy is on the rise: Roughly half of people diagnosed today can expect to live at least 5 more years, compared with 41% in 2000, according to one study.

Life expectancy with 45-50 % EF

My dad survived a heart attack a year ago. He’s 56 years old.
His EF a year later was 45-50 %. Otherwise he’s doing great, no symptoms of Heart Failure so far. My only concern is his life expectancy. He’s taking all his prescribed medication and also is being active, quit smoking.
If everything goes this way, what’s the life expectancy with this EF?

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7 Responses

Hi there. Your fathers heart seems to be doing well. 45-50% is quite good. His life expectancy is really only a matter for his doctor to discuss. I’m no doctor, but based on just the EF, I imagine he will lead as normal life provided he does whats required by the doctors to start with. Write down your concerns and go to the next appointment and get the clarity and peace of mind you need.

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COMMUNITY LEADER

His life expectancy should not be impaired by these numbers. Heart failure does not start unless his EF drops below 30% and he is well above that. He needs to follow his doctor’s instructions and retest as recommended. His next EF measurement may be back in the normal range over 55%.

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Anyone please?
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1 Comments

It is natural to be worried about this, but there is very little you can actually do to change your dad’s situation. If you are experiencing great anxiety, it would not hurt to get a bit of counseling. A good therapist can help a lot.

I’d love to hear from somone who has had similar story as mine, would be very helpful 🙂
Helpful – 0

Only your father’s cardiologist knows the details of your father’s heart function. I suggest you accompany your father to his next appointment to learn more.

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Anyone any other opinion?
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Erijon thank you for your answer 🙂
You really think his EF is going to be back on normal range soon?

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Have an Answer?
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Ejection Fraction

Ejection fraction measures your heart’s ability to pump oxygen-rich blood out to your body. In a healthy heart, the fraction is a higher number. A low number means that your heart has difficulty keeping up with your body’s needs. If you have or are at risk for heart failure, your healthcare provider will want to know your ejection fraction.

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What is ejection fraction?

Ejection fraction refers to how well your heart pumps blood. It is the amount of blood pumped out of your heart’s lower chambers (ventricles) each time it contracts.

To understand ejection fraction, it’s helpful to understand how blood flows through the heart:

1. Blood enters the heart through the top right section (atrium).
2. Between heartbeats, there’s a short pause. This is when blood flows through a valve down to the left ventricle.
3. Once the ventricle is full, the next heartbeat pumps out (ejects) a portion of the blood out to the body.

What is a normal ejection fraction?

Ejection fraction in a healthy heart is 50% to 70%. With each heartbeat, 50% to 70% of the blood in your left ventricle gets pumped out to your body.

Ejection Fraction Percentage

Some people with a normal ejection fraction also have heart failure. This is known as heart failure with preserved ejection fraction (HFpEF).

Why is it important to know my ejection fraction?

Your ejection fraction is an indicator of how well your heart is working. A low ejection fraction typically means you have or are at risk for heart failure.

Are there different types of ejection fractions?

Measurements can be taken on either the left or right ventricle.

Left ventricular ejection fraction (LVEF)

Ejection fraction typically refers to the left side of the heart. It shows how much oxygen-rich blood is pumped out of the left ventricle to most of the body’s organs with each contraction. LVEF helps determine the severity of dysfunction on the left side of the heart.

Right ventricular ejection fraction(RVEF)

This measures the amount of oxygen-poor blood pumped out of the right side of the heart to the lungs for oxygen. It is important if you have right-sided heart failure. But this condition is not as common as left-sided heart failure.

What is the ejection fraction formula?

The ejection fraction (EF) formula equals the amount of blood pumped out of the ventricle with each contraction (stroke volume or SV) divided by the end-diastolic volume (EDV), the total amount of blood in the ventricle. To express as a percentage, you would multiply by 100. So, EF = (SV/EDV) x 100.

In other words, the ejection fraction is the percentage of blood pumped out of the ventricle after a contraction.

What do ejection fraction numbers mean?

The lower the ejection fraction, the weaker your heart’s pumping action is. This occurs in people with severe heart failure. You can also have a low ejection fraction in the earlier stages of heart failure. Different treatments can help, depending on how far from normal your ejection fraction is.

How can HFpEF affect me?

With preserved ejection fraction (diastolic heart failure), contractions pump a large portion of blood out to your body. But the left ventricle holds a lower volume of blood. This is often because thick or stiff heart tissue effectively shrinks ventricle size. When this happens, the amount of blood pumped out to the body isn’t enough to meet its needs.

You may be at risk for heart failure with preserved ejection fraction if you have:

• Cardiac tamponade.
• Coronary artery disease.
• Heart valve disease.
• High blood pressure.

What does it mean if my ejection fraction is not within the normal range?

An ejection fraction outside of the normal range could mean a variety of things:

• 40% to 49% is mid-range ejection fraction: The heart’s pumping ability is slightly below normal. You might not experience heart failure symptoms. Or, you may have symptoms with physical activity but not at rest.
• 39% or less is heart failure with reduced ejection fraction (HFrEF): Pumping ability is below normal. The lower the ejection fraction, the higher the risk of life-threatening complications, like cardiac arrest. Symptoms may be severe and may affect you even when sitting still.

What causes reduced ejection fraction?

Ventricular contractions that pump blood out to the body need healthy muscle tissue. Conditions that weaken or damage heart muscles make contractions incomplete and less effective.

The heart may compensate by working harder to do its job. The extra work can lead to swelling or scar tissue buildup that affects the ventricle’s ability to fill and pump. You might not feel the effects of a slightly reduced ejection fraction. But as your heart function declines and your ejection fraction worsens, you can become severely ill.

What does it feel like to have a low ejection fraction?

The lower your ejection fraction, the more severe your heart failure symptoms may be. You might experience:

• Confusion.
• Fatigue.
• Heart palpitations.
• Nausea.
• Shortness of breath (dyspnea).
• Water retention in your abdomen or feet.
• Weakness.

What happens if my ejection fraction is higher than average?

An ejection fraction of 75% or more is rare but could be dangerously high. It can occur in people with hypertrophic cardiomyopathy.

Who should have their ejection fraction measured?

It’s helpful to know your ejection fraction if you have or are at risk for a condition that can lead to heart failure.

• ATTR amyloidosis, which can affect the heart.
• Cancer or other conditions requiring chemotherapy, which sometimes causes heart damage (cardiotoxicity).
• Congenital heart disease.
• Heart attack.
• Heart valve disease.
• Myocarditis.
• Severe high blood pressure.
• Ventricular arrhythmia.

How is my ejection fraction used to guide treatment?

It helps healthcare providers determine which heart failure treatment is best for your needs. Periodically checking ejection fraction throughout therapy shows whether heart function is improving.

Heart failure treatments include:

• Biventricular pacemaker.
• Heart failure medications.
• Heart transplant.
• Heart valve repair or replacement.
• Implantable cardioverter defibrillator (ICD).

How is ejection fraction measured?

There are a few methods for measuring ejection fraction. Echocardiogram is the most common.

Other heart tests that measure ejection fraction include:

• Cardiac catheterization.
• Cardiac computed tomography (CT) scan.
• Heart MRI.
• Multigated acquisition scan (MUGA), also called a nuclear stress test.

How can I improve my ejection fraction?

Heart failure therapies treat the underlying cause of low ejection fraction. For heart failure due to an arrhythmia, you may benefit from a biventricular pacemaker. People with heart failure due to other causes, like high blood pressure, may need medications.

You can take additional steps to relieve strain on your heart and get the most out of treatment. These include:

• Increasing physical activity. A cardiac rehabilitation program can help you safely get started.
• Maintaining a healthy weight.
• Limiting the amount of sodium and volume of fluids you consume.
• Quitting unhealthy habits, such as smoking, recreational drugs and alcohol.

How will I know if my ejection fraction is improving?

If you have a low ejection fraction, you’ll have frequent appointments with your healthcare provider to monitor it. It’s essential to go to all appointments, even if you don’t feel sick.

If your symptoms are fading, it may be a sign that ejection fraction is improving. But it’s also possible for symptoms to worsen or for new ones to appear. These issues may indicate a worsening ejection fraction.

Contact your healthcare provider immediately — do not wait until your next appointment — if you experience:

• Difficulty breathing, especially when lying down.
• A heartbeat that feels unusually fast.
• Loss of appetite or vomiting.
• Sudden weight change, which could be a sign of fluid retention.
• Unexplained weakness or dizziness.

How often should my ejection fraction be measured?

Healthcare providers may be concerned about your ejection fraction if you:

• Have symptoms of heart failure.
• Experience a heart attack or other condition that affects heart function.
• Are living with a condition that raises the risk of heart failure.

The frequency of testing after a heart failure diagnosis depends on a variety of factors, including how low your initial ejection fraction reading was. If your ejection fraction continues worsening, you’ll need it checked more frequently. If it is stable, you might not need it checked as often.

Is ejection fraction the only test for heart failure?

Ejection fraction is one of many parameters your healthcare providers use to assess heart failure. Additional testing makes it possible to pinpoint the cause so that you receive appropriate therapies.

These tests may include:

• Angiography.
• Chest X-ray.
• Echocardiogram.
• Electrocardiogram (EKG).
• Exercise stress test.

A note from Cleveland Clinic

Ejection fraction is an indicator of heart strength. It measures the amount of oxygen-rich blood pumped out to the body with each heartbeat. A low ejection fraction is typically a sign of heart failure. With treatments and self-care, it’s possible to raise your ejection fraction back into normal range.

Ways to Maximize Your Lifespan With Heart Failure

If you learn that you have heart failure, don’t let the name mislead you. Your heart hasn’t failed. Rather, you have a condition in which your heart has trouble pumping oxygen-rich blood to the rest of your body.

“That can result in a backup of fluid into the lungs and congestion in the lungs, causing shortness of breath, chest pain, and fatigue, as well as the backup of fluid elsewhere in the body,” says Brent Lampert, DO, a cardiologist at The Ohio State University Wexner Medical Center in Columbus.

Depending on how serious your heart failure is, you may notice swelling in your ankles and legs. Your heart may beat faster than usual, or its rhythm may not be as regular. Your stomach may swell, and you could lose your appetite.

It’s a serious diagnosis. But doctors have learned a lot about how to treat heart failure with close care, often including a combination of prescription drugs that provides the most relief from symptoms.

And life expectancy is on the rise: Roughly half of people diagnosed today can expect to live at least 5 more years, compared with 41% in 2000, according to one study.

Special calculators offer an estimate of your life expectancy with heart failure. With one online tool, the Seattle Heart Failure Model, you can put in your lab results and the type of treatment you’re getting to project your odds.

But keep in mind that such calculators are based on large groups of people and may not include the latest research, says Gregg Fonarow, MD, a cardiologist who directs the Ahmanson-UCLA Cardiomyopathy Center in Los Angeles.

“Even the most accurate risk models aren’t going to get it right for most individuals,” Fonarow says. “The best thing is talk to your physician, who can help you interpret all over your risk factors, rather than trying to figure out your risk on your own.”

What Determines Life Expectancy?

Some things that affect your life expectancy with heart failure are out of your control, such as your age. Others, such as a healthy lifestyle, are not.

Things that may affect life expectancy include:

Ejection fraction. To get a better picture of your heart health, your doctor will check how well an area of your heart called the left ventricle pumps out blood. An echocardiogram is one test that’s often used. It scans the heart and takes measurements to find out what percentage of your blood is being pumped out with each heartbeat. For instance, an ejection fraction of 55% means that 55% of your blood is being pushed out with each thump. A normal result usually falls between 50% and 70%, according to the American Heart Association.

People with a reduced ejection fraction have one type of the condition. It’s called heart failure with reduced left ventricular function. With the other type, heart failure with preserved left ventricular function, the percentage isn’t below normal. But there are other changes, such as the heart becoming stiffer. “After the heart squeezes and pumps blood forward, it has to relax to fill with blood,” Lampert says. “When the heart muscle is stiff or unable to relax as blood is trying to rush in and fill it, it’s not very compliant, and so you can get that same results of fluid backing up into the lungs and other parts of the body.”

If your heart failure involves a reduced ejection fraction, your doctor will watch that number closely. If it drops too low, to 35% or below, you have a higher risk of a possibly life-threatening heart rhythm.

Staging. There are four stages of heart failure, which indicate how serious your condition may be.

• Stage A: You don’t have full heart failure, but you have some risk factors. You may have a family member with heart failure. Or you may have other medical conditions, such as high blood pressure, alcohol abuse, diabetes, or heart disease.
• Stage B: Tests show that your heart has had some damage, but you don’t notice any symptoms. Most likely, you had a below-normal result on a heart function test. Most people with Stage B have an ejection fraction of 40% or less.
• Stage C: You have some symptoms that may come and go, such as tiredness. You may be less able to exercise, have swollen or weak legs, or have shortness of breath.
• Stage D: Your symptoms are more serious and don’t improve with medication and other treatment.

Lifestyle choices. There are things you can do today to improve the quality of your life as well as possibly extend it, Lampert says. Smokers should try to quit, and he advises bypassing alcohol. “I generally advise people to avoid it.”

Stay as active as possible under a doctor’s direction or with a cardiac program, Lampert says. Follow recommendations to limit sodium and how much fluid you drink.

Even these small dietary steps may have a large impact, Lampert says.

“One factor that is associated with a shorter length of life is recurrent hospitalizations,” he says. “Every time you are hospitalized, life expectancy shortens. If you can control fluid and sodium and stay out of the hospital, that can certainly help both quality and quantity of life.”

Keeping up with medications. This might seem obvious, but both Lampert and Fonarow stress the importance of not skipping your meds. You will probably need to take several medications for your heart failure. They may have side effects, and how well they work may change as your condition changes.

“When you do develop symptoms, report those, and stay in close contact with your physician,” Lampert says. “So if you are starting to worsen, they can act on it quickly.”

The good news is that recent research shows that taking a combination of medications for heart failure helps extend life expectancy in people with reduced ejection fraction, Fonarow says. In one study, the medication combination boosted survival by an average of 6 years across all age groups.

“There’s been an important and critical revolution in our ability to diagnose and treat patients with heart failure,” Fonarow says. “Because it’s not been any single one medication alone, but it’s this combination, it has not gotten the attention that it rightly deserves.”

Show Sources

Cleveland Clinic: “Heart Failure: Understanding Heart Failure.”

Brent Lampert, DO, cardiologist, Ohio State University Wexner Medical Center, Columbus.

BMJ: “Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population-based cohort study.”

Gregg Fonarow, MD, director, Ahmanson-UCLA Cardiomyopathy Center, Los Angeles.

Cleveland Clinic: “Echocardiogram.”

American Heart Association: “Ejection Fraction Heart Failure Measurement.”

Lancet: “Estimating lifetime benefits of comprehensive disease-modifying pharmacological therapies in patients with heart failure with reduced ejection fraction: a comparative analysis of three randomized controlled trials.”