# Left ventricular ejection fraction (LVEF) Biomarker · id `cardio:lvef` · Cardiovascular Atlas · release `f6f6f1b6f50379ed` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Also called: Ejection fraction; EF Browse, organ or system: Heart Browse, condition area: Heart failure ## In plain language A percentage that says how much of the blood in the left ventricle, the heart's lower left chamber, the heart pushes out on each beat. It shows how well the heart pumps. Doctors use it to sort heart failure into types, and an echocardiogram or other imaging test measures it. Each of the five medicine trials in this atlas used an ejection fraction rule to decide who could join. ## Technical summary NHLBI says an ejection fraction of 40% or less is heart failure with reduced ejection fraction, 50% or more is preserved, and 41% to 49% may be called borderline. The medicine trials in this atlas used 40% or less (DAPA-HF, EMPEROR-Reduced and PARADIGM-HF) or more than 40% (EMPEROR-Preserved and DELIVER). FINEARTS-HF, a finerenone trial, enrolled people with an ejection fraction of 40% or greater, which includes the 40% boundary. A trial of a pulmonary artery pressure sensor enrolled NYHA class III patients irrespective of ejection fraction. The shared echocardiography record links here as a way to measure it. ## Claims, with the population each applies to ## Context: Adults with heart failure, as described by NHLBI (heart failure health topic) Recipient: Adult; Population: Adults. NHLBI says this health topic is about adult heart failure and that children can be affected too.; Care setting: Not applicable (a description of the condition and its care).; Geography: United States (the prevalence figure is for US adults; the page names no other country).; Life stage: Adults.; Follow-up: Not applicable. ### NHLBI defines ejection fraction as the share of the left ventricle's blood that leaves the heart on each beat. It can be measured by echocardiography or other imaging, and NHLBI says it is used to identify the type of heart failure and to guide treatment. NHLBI puts a share of 40% or less in heart failure with reduced ejection fraction and a share of 50% or more in heart failure with preserved ejection fraction. For 41% to 49% it says a person may be given a diagnosis of a borderline type. - Category: Description - Evidence stage: Evidence stage unknown - Certainty: Certainty not assessed - Applies to: Recipient: Adult; Population: Adults. NHLBI says this health topic is about adult heart failure and that children can be affected too.; Care setting: Not applicable (a description of the condition and its care).; Geography: United States (the prevalence figure is for US adults; the page names no other country).; Life stage: Adults.; Follow-up: Not applicable. - Limitations: General patient information from a government health page last updated on March 24, 2022. The cut-offs are NHLBI's wording for patients. The trials in this atlas use their own entry rule of 40% or less (DAPA-HF, EMPEROR-Reduced, PARADIGM-HF) or above 40% (EMPEROR-Preserved, DELIVER), so a trial of heart failure with an ejection fraction above 40% includes people NHLBI would call borderline. The page is cite only, so no wording is quoted here. - Last checked: 2026-10-14 - Sources: 1. Supports: NHLBI: Heart Failure: Diagnosis (Webpage, edition NHLBI health topic page fetched 2026-10-14. The page says it was last updated on March 24, 2022.) Locator: Diagnosis, ejection fraction section, paragraph 1. Retrieved 2026-10-14T18:20:46Z. Source state: Current. Snapshot hash: afbec0fc62b82ea8fea8a8cea7ee8fb6f20c31dde6b705f85c52f85d20be1752. How it applies: What ejection fraction is and what it is used for. NHLBI page last updated March 24, 2022 according to the page; cite only, so this atlas restates it in its own words. 2. Supports: NHLBI: Heart Failure: Diagnosis (Webpage, edition NHLBI health topic page fetched 2026-10-14. The page says it was last updated on March 24, 2022.) Locator: Diagnosis, ejection fraction section, thresholds. Retrieved 2026-10-14T18:20:46Z. Source state: Current. Snapshot hash: afbec0fc62b82ea8fea8a8cea7ee8fb6f20c31dde6b705f85c52f85d20be1752. How it applies: The cut-offs for reduced, preserved and borderline. NHLBI page last updated March 24, 2022 according to the page; cite only, so this atlas restates it in its own words. ## Connected pages - Ejection fraction is used to sort heart failure into types: Heart failure with reduced ejection fraction (HFrEF) (`cardio:hfref`) - Ejection fraction is used to sort heart failure into types: Heart failure with mildly reduced or preserved ejection fraction (`cardio:hfpef`) - Measured by: Echocardiography (`core:echocardiography`) ## Provenance Content hash: 79afd3b097008674736f33c2300ab7ad949accd6feacfd7d8fb7de239f26f06b Last substantive edit: 2026-10-15 Evidence last checked: 2026-10-14