Cardiovascular Atlas
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Left ventricular ejection fraction (LVEF)

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.

Also called Ejection fraction · EF

  • Biomarker
  • In this atlas

Overview

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. CHAMPION enrolled NYHA class III patients irrespective of ejection fraction. The shared echocardiography record links here as a way to measure it.

What is measured

Measure
Percent of the left ventricle's blood that is pumped out with each heartbeat
Assay context
Echocardiography or other imaging tests (NHLBI)

Interpretation

  • Description Evidence stage unknown Certainty not assessed

    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.

    Applies to Adult
    • Adults. NHLBI says this health topic is about adult heart failure and that children can be affected too.
    • Not applicable (a description of the condition and its care).
    • United States (the prevalence figure is for US adults; the page names no other country).
    • Adults.
    Follow-up Not applicable.
    Certainty method
    Not assessed
    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
    Next evidence check due
    Not scheduled
    Sources and citations (2)

    1. Supports NHLBI: Heart Failure: Diagnosis

      Webpage · National Heart, Lung, and Blood Institute (NIH) · 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
      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.
      Retrieved
      Source effective date
      2022-03-24
      Source state
      Current
      Snapshot hash
      afbec0fc62b82ea8fea8a8cea7ee8fb6f20c31dde6b705f85c52f85d20be1752
      Reuse basis
      NHLBI web page. The page states no reuse terms, and the NHLBI Website, Privacy, and Accessibility page (fetched as ce-nhlbi-website-privacy-accessibility.html, sha256 4a2dc26d04f8c22437502b5215031c1fb652759638b50552690d8b1383dd723c) does not either. The NIH web policies page returned HTTP 403 (ce-nih-web-policies.html) and was not worked around. Reuse terms are therefore unverified, and this atlas treats the page as cite only: the facts are stated in its own words with the citation and link. Only the hash is kept.

    2. Supports NHLBI: Heart Failure: Diagnosis

      Webpage · National Heart, Lung, and Blood Institute (NIH) · 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
      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.
      Retrieved
      Source effective date
      2022-03-24
      Source state
      Current
      Snapshot hash
      afbec0fc62b82ea8fea8a8cea7ee8fb6f20c31dde6b705f85c52f85d20be1752
      Reuse basis
      NHLBI web page. The page states no reuse terms, and the NHLBI Website, Privacy, and Accessibility page (fetched as ce-nhlbi-website-privacy-accessibility.html, sha256 4a2dc26d04f8c22437502b5215031c1fb652759638b50552690d8b1383dd723c) does not either. The NIH web policies page returned HTTP 403 (ce-nih-web-policies.html) and was not worked around. Reuse terms are therefore unverified, and this atlas treats the page as cite only: the facts are stated in its own words with the citation and link. Only the hash is kept.

Record details

Record id
cardio:lvef
Content hash
019a8c6223884276e28bf6c09fe2ceb6a7e55958545355ece0d4c66918eb2b5b