How to Improve Heart Ejection Fraction

Ejection fraction (EF) measures the percentage of blood pumped out of the heart’s main pumping chamber, the left ventricle, with each beat. It indicates how effectively your heart is functioning. A healthy heart typically has a left ventricular ejection fraction (LVEF) ranging from about 55% to 70%. An LVEF between 41% and 49% is considered mildly reduced, while 40% or less indicates a reduced ejection fraction. A low ejection fraction suggests the heart is not pumping enough blood to meet the body’s needs, which can signal underlying heart problems like heart failure.

Lifestyle Approaches to Support Heart Function

Dietary modifications support heart health. The Dietary Approaches to Stop Hypertension (DASH) diet emphasizes fruits, vegetables, whole grains, and lean protein sources like fish, poultry, and beans. This eating plan limits foods high in saturated fat, added sugars, and sodium.

Reducing sodium intake is important, as excessive sodium can raise blood pressure and strain the heart. The American Heart Association recommends limiting sodium, ideally to no more than 1,500 mg per day for most adults. Most sodium comes from processed and restaurant foods, making label reading and home cooking beneficial.

Regular physical activity strengthens the heart muscle and enhances overall cardiovascular function. Adults should aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity each week. This can include activities like brisk walking, swimming, or cycling, along with muscle-strengthening activities at least twice a week.

Managing stress also contributes to heart health, as chronic stress can lead to increased blood pressure and inflammation. Techniques such as deep breathing exercises, mindfulness, meditation, and engaging in hobbies can help reduce stress levels. Prioritizing adequate sleep, typically 7-9 hours per night, is also important for stress management and overall well-being.

Quitting smoking significantly reduces the risk of heart failure. Current smoking is associated with an increased risk of both reduced and preserved ejection fraction heart failure. While the risk decreases over time after quitting, it can take many years for a former smoker’s heart failure risk to align with that of someone who has never smoked.

Moderating alcohol consumption is advised for heart health. For healthy adults, current guidelines suggest limiting intake. For individuals with existing heart conditions, abstaining or limiting intake to one drink or less per day may be recommended due to potential adverse effects like increased blood pressure, cholesterol, and irregular heartbeats.

Medical Interventions for Ejection Fraction Improvement

For individuals with diagnosed heart conditions affecting ejection fraction, medical interventions often involve a combination of medications. Angiotensin-converting enzyme (ACE) inhibitors, such as enalapril or lisinopril, relax blood vessels to lower blood pressure and reduce the heart’s workload. Angiotensin II receptor blockers (ARBs), including valsartan or losartan, offer similar benefits and are an option for those who cannot tolerate ACE inhibitors.

Beta-blockers, such as carvedilol or metoprolol, slow the heart rate and lower blood pressure, helping the heart function more efficiently and potentially extending life for those with heart failure. Diuretics, often called “water pills” like furosemide, help prevent fluid buildup in the body and lungs, easing breathing by increasing urination. Potassium-sparing diuretics, such as spironolactone, may also be used, particularly in severe cases of heart failure with reduced ejection fraction.

Angiotensin receptor-neprilysin inhibitors (ARNIs), like sacubitril-valsartan, combine two blood pressure medications and are used for some individuals with reduced ejection fraction to help prevent hospitalizations. Sodium-glucose cotransporter-2 (SGLT2) inhibitors, such as dapagliflozin or empagliflozin, initially used for type 2 diabetes, are now recognized as effective treatments for heart failure, reducing hospitalizations and mortality. Digoxin can help the heart contract more effectively and slow the heartbeat, reducing symptoms in certain cases.

Beyond medications, device-based therapies can play a role in managing and improving ejection fraction. Implantable cardioverter-defibrillators (ICDs) are similar to pacemakers and are placed under the skin in the chest. They monitor heart rhythm and deliver electrical shocks to correct dangerous rhythms or pace a slow heartbeat.

Cardiac resynchronization therapy (CRT), also known as biventricular pacing, involves a device that sends electrical signals to the lower heart chambers, causing them to contract in a more coordinated way. This synchronized contraction improves the heart’s pumping efficiency. CRT may be recommended for individuals with moderate to severe heart failure and irregular heart signaling, sometimes combined with an ICD (CRT-D).

The Role of Professional Medical Guidance

Consulting healthcare professionals is important for accurate diagnosis and ongoing management of ejection fraction. Self-treating or making changes to lifestyle or medication without medical supervision can be detrimental to heart health.

A doctor can conduct appropriate diagnostic tests, such as an echocardiogram, to measure ejection fraction and determine the underlying cause of any changes. Healthcare providers develop personalized treatment plans based on an individual’s specific symptoms, medical history, and overall heart condition. They can monitor the effectiveness of interventions and adjust medications or therapies as needed. Regular follow-up appointments ensure continuous monitoring of ejection fraction and overall heart health, helping to optimize outcomes and prevent complications.

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