Does an echocardiogram (echo) show ejection fraction?

Does an Echo Complete Show Ejection Fraction?

Yes, an echocardiogram (echo) complete does show ejection fraction, which is a key measurement of left ventricular systolic function and is routinely calculated during standard echocardiographic examinations. 1

How Ejection Fraction is Measured on Echocardiography

An echocardiogram provides both qualitative and quantitative assessments of left ventricular systolic function:

1. Quantitative Measurement:

   • Left ventricular ejection fraction (LVEF) can be calculated using various methods:
     • Visual estimate by experienced echocardiographers 2
     • Calculated LVEF using formulas such as:
       • Simpson's biplane method
       • Teichholz method
       • Cube method 3
   • The calculated LVEF is reported as a percentage (%) 1

2. Qualitative Assessment:

   • Left ventricular systolic function is also described qualitatively as:
     • Normal (LVEF 50-70%)
     • Hyperdynamic (LVEF >70%)
     • Mildly reduced (LVEF 40-49%)
     • Moderately reduced (LVEF 30-39%)
     • Severely reduced (LVEF <30%) 1, 4

Clinical Significance of Ejection Fraction

Ejection fraction measurement is crucial for:

• Heart Failure Classification:

  • Heart failure with reduced ejection fraction (HFrEF): LVEF <40%
  • Heart failure with mid-range ejection fraction (HFmrEF): LVEF 40-49%
  • Heart failure with preserved ejection fraction (HFpEF): LVEF ≥50% 1

• Treatment Decisions:

  • Guides medication choices and dosing
  • Helps determine need for devices (e.g., implantable cardioverter-defibrillators)
  • Influences surgical candidacy for various cardiac procedures

• Prognostic Value:

  • Lower LVEF values correlate with increased mortality and morbidity 1
  • Changes in LVEF over time help assess response to treatment

Important Considerations

• Limitations:

  • Image quality affects accuracy of LVEF calculation
  • Inter-observer and intra-observer variability exists 2
  • Different imaging techniques (echo, cardiac MRI, nuclear imaging) may yield slightly different LVEF values for the same patient 5

• Availability:

  • While echocardiography is widely available in most healthcare settings, access may be limited in some rural or resource-constrained environments 6

• Beyond LVEF:

  • A complete echo also assesses diastolic function, which can be abnormal even with preserved LVEF 1, 7
  • Other parameters like global longitudinal strain may provide additional insights into cardiac function, especially when LVEF is preserved 1

Echocardiography remains the most accessible and widely used method for measuring ejection fraction in clinical practice, providing crucial information for diagnosis, treatment planning, and prognostication in patients with suspected or known cardiac disease.