Ejection fraction (EF) measures how effectively the heart pumps blood with each beat. It is a percentage of the blood ejected from a heart chamber, usually the left ventricle, with each contraction. Understanding EF is important for assessing heart health and guiding treatment. This article explores how EF is measured, what different values signify, and approaches to support its improvement.
What Ejection Fraction Means
The left ventricle is the heart’s main pumping chamber, responsible for sending oxygen-rich blood to the rest of the body. A healthy heart has a left ventricular ejection fraction (LVEF) ranging from 50% to 70%. This means 50% to 70% of the blood within the left ventricle is pushed out into circulation with each contraction.
When LVEF falls below this range, it indicates the heart is not pumping efficiently. An LVEF between 41% and 49% is considered mildly reduced, while 40% or less is classified as a reduced LVEF, often signaling heart failure. A lower ejection fraction can result from conditions that weaken or damage the heart muscle. Common causes include heart failure, damage from a previous heart attack, cardiomyopathy, heart valve problems, and long-term, uncontrolled high blood pressure.
Medical Interventions for Improvement
Medical strategies are employed to improve ejection fraction and support heart function. Medications are a primary approach, with several classes designed to reduce the heart’s workload and enhance its pumping ability. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) relax blood vessels, lowering blood pressure and decreasing strain on the heart. Beta-blockers, such as carvedilol or metoprolol, slow the heart rate and reduce blood pressure, helping the heart work more efficiently and protecting it from further damage.
Diuretics, often called “water pills,” help the body eliminate excess fluid, which can reduce fluid buildup in the lungs and other areas, making breathing easier and decreasing the heart’s burden. Newer medications, such as SGLT2 inhibitors and angiotensin receptor-neprilysin inhibitors (ARNIs), have also shown benefits in improving ejection fraction by optimizing heart function and preventing hospitalizations. For some individuals, medical devices may be implanted to help the heart pump more effectively. These include pacemakers, which help coordinate heartbeats, or implantable cardioverter-defibrillators (ICDs), which deliver electrical shocks to correct dangerous heart rhythms. Surgical options, such as valve repair or replacement for diseased heart valves, or coronary artery bypass grafting (CABG) to improve blood flow to the heart muscle, are also considered to address underlying issues affecting ejection fraction.
Lifestyle Adjustments for Heart Support
Lifestyle changes play a significant role in supporting heart health and can contribute to improving ejection fraction when combined with medical treatment. Adopting a heart-healthy diet is foundational, emphasizing fruits, vegetables, whole grains, and lean proteins while limiting sodium, saturated fats, and processed foods. Following dietary patterns like the DASH or Mediterranean diet can help manage blood pressure and cholesterol levels, reducing strain on the heart.
Regular physical activity, such as moderate aerobic exercise, strengthens the heart muscle and improves its pumping efficiency. Managing stress through techniques like mindfulness or deep breathing can also benefit the heart, as chronic stress can negatively impact blood pressure and heart function. Quitting smoking significantly reduces the risk of heart disease and improves cardiovascular health. Limiting alcohol consumption and maintaining a healthy weight further reduce the workload on the heart, helping it to pump more efficiently and improving ejection fraction.
Ongoing Management and Monitoring
Ongoing monitoring and collaboration with a healthcare team are important for managing ejection fraction and optimizing heart health. Regular check-ups allow healthcare professionals to track progress, assess treatment effectiveness, and make necessary adjustments to medication or lifestyle plans. These appointments are important even if symptoms improve, as ongoing assessment helps ensure the heart continues to function well.
Diagnostic tests are routinely used to measure and monitor ejection fraction over time. An echocardiogram, which uses sound waves to create images of the heart, is the most common method for this assessment. Other imaging techniques, such as cardiac MRI or cardiac computed tomography (CT) scans, may also be used to provide detailed views of the heart’s structure and function. Adherence to prescribed medications and consistent application of lifestyle recommendations are important for long-term success in improving and maintaining ejection fraction.