Left ventriculography Left Ventricular Ejection Fraction Assessment by Visual Estimation

Coronary Angiography
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Left ventriculography
Technique Quantification of LV Function Quantification of Mitral Regurgitation

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Left ventricular ejection fraction (LVEF) can be estimated by visual inspection of the end-systolic and end-diastolic frames on left ventriculography.

Classification

According to the ACC Heart Failure Clinical Toolkit, based on the quantitative results of LVEF assessment, left ventricular function can be classified into the following qualitative categories:

• Hyperdynamic = LVEF greater than 70%
• Normal = LVEF 50% to 70% (midpoint 60%)
• Mild dysfunction = LVEF 40% to 49% (midpoint 45%)
• Moderate dysfunction = LVEF 30% to 39% (midpoint 35%)
• Severe dysfunction = LVEF less than 30%

Examples

Hyperdynamic (>70%)

Case 1: LVEF=80%

• End-diastolic frame
  End-diastolic frame
• End-systolic frame
  End-systolic frame
• Left ventriculography
  Left ventriculography

Case 2: LVEF=80%

• End-diastolic frame
  End-diastolic frame
• End-systolic frame
  End-systolic frame
• Left ventriculography
  Left ventriculography

Normal LVEF (50–70%)

Case 1: LVEF=80%

• End-diastolic frame
  End-diastolic frame
• End-systolic frame
  End-systolic frame
• Left ventriculography
  Left ventriculography

Case 2: LVEF=80%

• End-diastolic frame
  End-diastolic frame
• End-systolic frame
  End-systolic frame
• Left ventriculography
  Left ventriculography

Mild dysfunction (40–49%)

Case 1: LVEF=80%

• End-diastolic frame
  End-diastolic frame
• End-systolic frame
  End-systolic frame
• Left ventriculography
  Left ventriculography

Case 2: LVEF=80%

• End-diastolic frame
  End-diastolic frame
• End-systolic frame
  End-systolic frame
• Left ventriculography
  Left ventriculography

Moderate dysfunction (30–39%)

Case 1: LVEF=80%

• End-diastolic frame
  End-diastolic frame
• End-systolic frame
  End-systolic frame
• Left ventriculography
  Left ventriculography

Case 2: LVEF=80%

• End-diastolic frame
  End-diastolic frame
• End-systolic frame
  End-systolic frame
• Left ventriculography
  Left ventriculography