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Decreased keft ventricul ejection fraction

Poluneeru profile image
18 Replies

Hi all, went for my annual echocardiogram and was told my left ventricular ejection fraction is 50% and it is 5 % lower than last year. It normally stays at 55 % . Has appointment with my dr next weekWant to ask my friends here is it something concerning. Just want to get the opinion from people who experienced it. Will it get better. I am just worried thatvam I going in heart failure

Thank

Padma

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Poluneeru profile image
Poluneeru
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18 Replies
CDreamer profile image
CDreamer

I would be happy with that EF number, HF is when an EF would fall below 35%. Also remember that it will only ever be an estimated number and other factors do need to be considered for a diagnosis of HF.

Also it is a very emotive term which means that your heart isn’t pumping oxygenated blood to your body as effectively as it should. If you have no symptoms then I would forget about it and get on with living your best life.

My husband had an EF of 36% in 2018 and close to HF. AF was controlled - EF is now 58% so yes it can improve.

Coco51 profile image
Coco51 in reply to CDreamer

Interesting. My own post about my HF diagnosis is above this one. I am so glad to hear your husband's EV has improved. Reassuring for me to hear it too.

Poluneeru profile image
Poluneeru in reply to CDreamer

Thank you

Poluneeru profile image
Poluneeru in reply to CDreamer

Thank you

Poluneeru profile image
Poluneeru in reply to CDreamer

Thank you

Coco51 profile image
Coco51

I am in a similar boat and waiting for answers. My post is above (or below) this. Getting some good advice. Fingers crossed for us both xx

Poluneeru profile image
Poluneeru in reply to Coco51

Yes. Has an appointment with my doctor next week. Just nervous thinking what he is going to say. Hope everything goes well for both of us

Popepaul profile image
Popepaul

I think that you are currently nowhere near what could be called heart failure, you are towards the lower end of normal. I believe that EF is another term for stroke volume. From my younger days I know that stroke volume can improve with exercise. With Afib most clinicians seem to suggest that you avoid anaerobic exercise for the most part.Regards.

Poluneeru profile image
Poluneeru in reply to Popepaul

Thank you

Anon2023 profile image
Anon2023

hi. There is always a margin of error in all scans (+ or -) especially with different technicians. I had 2 different scans within a couple of months of each other that showed my EF as 44% and 53%. The cardiologist went with 53% but it just goes to show what a difference there can be.

BenHall1 profile image
BenHall1

Hi,

Just copying my comments on Ejection Fraction made to another forum member a few weeks ago. hope it maybe of interest to you. Apologies in advance for the length.

"Well, to start with I don't know how much you know about Ejection Fraction ... nor do I know how old you are ....... so, bear in mind I hold a PCV licence and still drive buses part time these days but I still have to jump through hoops with my annual DVLA inspired medical. As a matter of interest a normal Ejection Fraction is reckoned to be in the vacinity of 52 to 72.

So, forgive me if I am telling you something you already know but lets look at the definition of Ejection Fraction .....

Your doctor may talk about the ‘ejection fraction’ of your heart. This is to do with the amount of blood squeezed out of the main chamber of the heart with every beat. It’s usually measured as a percentage – over 50% is considered normal. Your ejection fraction is measured from an echocardiogram.

Heart Failure can be put into different groups depending on your ejection fraction. Depending on the percentage measured, and other tests, your heart failure may be classed as the following:

i) heart failure with preserved ejection fraction (HFpEF) - >50%)

ii) heart failure with mildly reduced ejection fraction (>40% - 49%)

iii) heart failure with reduced ejection fraction (<40%).

So, that covers the definition. Next I am taking an extract from my last 2 Echocardiograms ... the first taken in October 2020

1 Oct 2020 ....Left Ventricle: Normal LV dimension with mild concentric hypertrophy. Normal systolic function (EF 68%). Grade 1 diastolic dysfunction.

2 November 2022 ….

a) This 78 year old man who is in sinus rhythm has severe concentric left ventricular hypertrophy with a maximal wall thickness of 1.7cm. The left ventricle is not dilated and has normal systolic and diastolic function with an LVEF greater than 60 % .

b) Left Ventricle: Normal LV cavity size by internal dimensions. There is severe concentric LVH with severely increased LV mass when indexed to BSA. Normal LV systolic function. EF estimated >60% using Simpsons bi-plane/2D teich. No obvious RWMA. Normal diastolic function for patient age.

Hope all that helps. As you can see, in just 2 years the state of my heart has in some respects deteriorated. When I had my last (Nov 2022) Echo I asked the guy what he thought ( about my heart) ....... he just said, blandly, well its really done some hard work ! My GP on the other hand when I discussed it with her sdeemed to think it was okay ..... consistent with age !

I wish I could give you better comments but this is just my take on the issue. By the way, in case you are wondering in my case ... about "severe concentric left ventricular hypertrophy " means

"Concentric left ventricular hypertrophy is an abnormal increase in left ventricular myocardial mass caused by chronically increased workload on the heart, most commonly resulting from pressure overload-induced by arteriolar vasoconstriction as occurs in, chronic hypertension or aortic stenosis".

I have edited my original post as it contains references to Driving Licence authorities here in UK and I see you are in USA and therefore would have little relevance. I go along with the comments from CDreamer. As an aside, my EF still meets the approval of UK driving licence authorities for driving both car and bus.

John

Poluneeru profile image
Poluneeru in reply to BenHall1

Thank you for explaining in detail. I dont know much about ejection fraction. Stll learning. So if echocardiogram is done by 2 different technicians they can come up 2 different ejection fractions??. Sorry I am just trying to understand

BenHall1 profile image
BenHall1 in reply to Poluneeru

Hi,

Both my readings were taken at the same practice, two years apart but by different technicians ... that said the second technician would have had access to my earlier readings. So too, did my GP. What I don't know is how much the current technician was influenced by the write up of the first technician. That said, both reports were written up by the senior practioner of the practice undertaking the ECG.

Mugsy15 profile image
Mugsy15

EF can be read differently by the same technician, never mind two! It's a figure that fluctuates in the same way that blood pressure measurement does, and like many medical measurement methods, the one used for EF is an approximation. As others have said, 50% is well above a cause for concern. The 5% drop may prompt further checks in due course to see if it becomes a trend, but as things stand you're nowhere near heart failure. When I was in persistent AF before Cardioversion then Ablation, my EF was 46% and that wasn't considered unduly low in the circumstances.

Poluneeru profile image
Poluneeru in reply to Mugsy15

Thank you so much for explaining in detail. My appointment with my doctor is next week I wasworried from the time the echocardiogram is done. Now with all the kind people responses I feel little relieved. Will update what my doctor says after my appointment

BenHall1 profile image
BenHall1 in reply to Mugsy15

Hiya Mugsy15,

In the context of your last sentence - you are likely correct, but, try telling that to DVLA when you apply for driving licence renewal. They have their own guidelines and if your EF is too low then your licence will not be renewed. End of ! The higher category licence you have ... PCV, LGV or HGV the worse these guidelines become.

John

Mugsy15 profile image
Mugsy15 in reply to BenHall1

Interesting, I didn't know that. I've never had any dealings of that nature with the DVLA as I've never had to renew my licence.

BenHall1 profile image
BenHall1 in reply to Mugsy15

Hi Mugsy,

I'm what my kids in Australia call an Ancient Briton on account of my age (79). I hold a bog standard driving licence with PCV entitlement. Back in the day once you reached 70 you had to have an annual medical for the PCV but it was a blanket thingo as it also covered your basic driving licence. This age has now been reduced to 65 for PCV and automatically ropes in the bog standard licence too. My present employer ( I still drive buses part time ) a national bus operator, arranges my annual medical. All medical defects ( like AF) are fully notified to DVLA (and my private vehicle insurers) - no sweat.

John

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