From the Guidelines
Left Ventricular Ejection Fraction (LVEF) in Athletes
The left ventricular ejection fraction (LVEF) in athletes is typically within the normal range of 55-70% 1. However, intense physical training can lead to physiological adaptations, resulting in an LVEF range of 60-80% in highly trained athletes.
- Key factors to consider when evaluating LVEF in athletes include:
- Physiological adaptations: Intense physical training can lead to changes in cardiac structure and function, including increased left ventricular (LV) volume and wall thickness 1.
- Normal range: An LVEF of 55-70% is considered normal in athletes, although values up to 80% can be seen in highly trained individuals 1.
- Contractile reserve: Athletes with a normal LVEF typically demonstrate good myocardial contractile reserve, as evidenced by an increase in LVEF of at least 10% following exercise or achieving a maximal LVEF >63% 1.
- Notably, athletes with an LVEF above 80% may be at increased risk for cardiac fatigue, although this is not universally agreed upon and more research is needed to fully understand this relationship.
- It is essential to consider the individual athlete's characteristics, such as their sport, training level, and medical history, when interpreting LVEF values 1.
From the Research
Left Ventricular Ejection Fraction (LVEF) in Athletes
- The LVEF in athletes can be lower than normal, with some studies showing values <52% 2
- A study of 70 athletes with low LVEFs (<52%) found that they had longer LV contraction times, but no electrical dyssynchrony or differences in cardiac dimensions compared to athletes with normal LVEFs 2
- Peak aerobic performance was found to be independent of LVEF in athletes 2
- Another study found that highly trained women athletes frequently demonstrate cardiac dimensional changes, but absolute left ventricular cavity size exceeding normal limits was evident in only a minority (8%) of women athletes 3
- The normal modal LVEF is considered to be around 62% 4
- A study comparing left ventricular function in trained and untrained healthy subjects found that athletes had similar increases in left ventricular ejection fraction during exercise, but used different mechanisms to achieve these increases, such as decreasing end-systolic volumes instead of increasing end-diastolic volumes 5
Factors Affecting LVEF in Athletes
- Training intensity and duration can affect LVEF, with moderate-intensity continuous training (MICT) significantly increasing LVEF in heart failure patients with reduced ejection fraction (HFrEF) 6
- High-intensity interval training (HIIT) can also increase LVEF, but may not be different from MICT 6
- Resistance training alone or combined with aerobic training did not significantly change LVEF in HFrEF patients 6