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Heart Failure with Preserved Ejection

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What are Ejection Fractions?

What are Ejection Fractions?

Ejection fraction (EF) refers to a measurement of the percentage of blood your left ventricle pumps out with each heartbeat. EF is expressed as a percentage with normal typically ranging between 50 percent and 70 percent.

A typical EF isn’t automatically indicative of a healthy heart and an abnormal EF doesn’t exactly mean that your heart is dysfunctional. EF is only one piece of many clues of your overall heart. A NewYork-Presbyterian healthcare professional can use your EF, alongside other symptoms and test results, to get a better idea of your overall heart function.

Here’s a breakdown of different types of heart failure based on EF:

  • HFrEF. People with heart failure with reduced ejection fraction (HFrEF) have an EF that is 40 percent or lower. This is also called systolic heart failure.
  • HFpEF. People with heart failure with preserved ejection fraction (HFpEF) do not have much change in their ejection fraction. This is often called diastolic heart failure. The heart muscle contracts normally but is stiff so it can’t fill properly.
  • HFmrEF. Heart failure with mildly reduced ejection fraction. This is defined as an intermediate type of heart failure.

Symptoms & How EF is Measured

How are Ejection Fractions Measured?

An echocardiogram is the most common way to measure EF. This is a type of ultrasound that shows your heart contractions.

Symptoms of an atypical EF can range in intensity, from mild to extreme. Some of the most common symptoms may include:

  • Shortness of breath, especially when lying down or exercising
  • Fatigue and weakness
  • Swelling in the ankles, legs or abdomen
  • Rapid weight gain from fluid buildup
  • Persistent cough or wheezing
  • Difficulty concentrating or confusion
  • Rapid or irregular heartbeat
  • Coughing or wheezing
  • Nausea or lack of appetite

What is heart failure with preserved ejection fraction (HFpEF)?

What is HFpEF?

Heart failure with preserved ejection fraction (HFpEF) is a type of heart failure where the heart pumps normally but is stiff and doesn’t fill properly. As a result, patients with HFpEF experience symptoms of heart failure despite normal pumping function. 

Symptoms of HFpEF

Symptoms of HFpEF

Common symptoms of HFpEF include:

  • Shortness of breath during activity or at rest; worsening when lying flat
  • Tiredness and new difficulty with exercise
  • Leg swelling (edema) from fluid build-up

Causes & risk factors

Risk Factors

HFpEF can develop as a result of other chronic conditions, such as:

  • Hypertension
  • Obesity, metabolic syndrome, diabetes
  • Coronary artery disease, valvular disease, atrial fibrillation
  • Aging, sedentary lifestyle, chronic kidney or lung disease, sleep apnea

Over time, these conditions can lead to stiffening in the heart.

 

This content has been reviewed by the following medical editors.

Dr. Parag Goyal, M.D., M.S.c