Is a left ventricular ejection fraction (LVEF) of 63% with normal left ventricular size and no regional wall motion abnormalities within the normal range?

Normal Left Ventricular Ejection Fraction Assessment

Yes, a left ventricular ejection fraction (LVEF) of 63% with normal left ventricular size and no regional wall motion abnormalities is within the normal range.

Normal LVEF Range According to Guidelines

The American College of Cardiology/American Heart Association (ACC/AHA) guidelines define a normal ejection fraction as ranging from 50% to 70% (with a midpoint of 60%) 1. According to the 2019 ACC/AHA/ASE guidelines for transthoracic echocardiography, left ventricular systolic function is categorized as follows 2:

• Normal: LVEF 50-70%
• Hyperdynamic: LVEF >70%
• Mildly reduced: LVEF 40-49%
• Moderately reduced: LVEF 30-39%
• Severely reduced: LVEF <30%

The European Association of Cardiovascular Imaging (EACVI) similarly defines normal LVEF ranges, with slight gender differences in their 3D echocardiography reference values 2:

• Normal 3D LVEF: >54% for men, >57% for women

Interpretation of Your Results

Your echocardiogram results show:

1. Normal left ventricular size
2. LVEF of 63%
3. No regional wall motion abnormalities

This combination represents completely normal left ventricular systolic function. The LVEF of 63% falls squarely within the normal range (50-70%) and is actually slightly above the midpoint of 60%, indicating excellent systolic function.

Clinical Significance

Having a normal LVEF is associated with better clinical outcomes:

• Patients with normal LVEF (≥55%) have significantly lower risk of developing heart failure compared to those with low normal LVEF (50-55%) or reduced LVEF (<50%) 3.
• The absence of regional wall motion abnormalities indicates there is no evidence of prior myocardial infarction or ischemia affecting specific segments of the left ventricle.
• Normal left ventricular size rules out pathological ventricular remodeling that can occur in various cardiac conditions.

Important Considerations

While your LVEF is normal, it's worth noting that:

• LVEF is just one parameter of cardiac function. A comprehensive cardiac assessment should include evaluation of diastolic function, valvular function, and right ventricular function.
• LVEF can be affected by loading conditions, so it should be interpreted in the clinical context.
• Different imaging modalities (echocardiography, cardiac MRI, nuclear imaging) may yield slightly different LVEF measurements, though they generally correlate well 4.

Conclusion

Based on current guidelines, an LVEF of 63% with normal left ventricular size and no regional wall motion abnormalities represents normal cardiac systolic function. This finding is reassuring from a cardiac function perspective.