Ejection fraction of the left ventricle of the heart: norms, reasons for a decrease and high, how to increase. Heart Ejection Fraction Norms Low Fraction

Normal work of the heart is an alternating cyclical alternation of contractions of the muscle layer (myocardium) and complete relaxation, during which the organ rests from the load and prepares for the next beat.

In each systole (contraction), blood is pushed into the aorta, a large circle, and from there spreads throughout the body. The ejection fraction (EF) is a functional indicator, the ratio of the blood released from the left ventricle to the blood returning to it.

For the calculation, special formulas are used. As a general rule, the assessment is carried out in this way. Take the amount of blood thrown into the aorta, take away the end diastolic volume (EDV, which returned). The total is multiplied by 100% to get a specific value.

All calculations are performed automatically during echocardiography. According to Simpson, the formula is more accurate and is used in modern devices, and according to Teicholz, it is used in outdated equipment. The difference between the results can be up to 10%.

Attention is focused on reduced emissions (less than 45%). Symptoms are varied, because insufficient blood circulation leads to ischemia of all tissues and organs.

Treatment starts early. The degree of deviation, progression proportionally reduce the likelihood of a favorable outcome.

Above is the basic calculation method. It has no great practical value for the patient.

In automatic mode, the level is calculated by instrumental methods using the program preinstalled on the device for ECHO KG.

The norm of the left ventricular ejection fraction (LVEF) in adults is in the range of 50-85%. The first number is considered the lower limit at rest, the second is the maximum after exercise.

In this case, cardiac output is an individual indicator. But it should not fall below the named level. The critically low limit of PV is 45%. Anything less is a direct indication of a pathological process.

To talk about the norm, you need to know the working numbers of a person. The condition can be assessed only with prolonged observation of the patient.

Attention:

Indicators of the ejection fraction of the heart below 35% indicate a significant, irreversible violation of the functional activity of the heart. Prognostically unfavorable sign. It is no longer possible to fundamentally help the patient.

Symptoms

The manifestations are different. Left ventricular ejection fraction indicates the force with which blood is expelled into the aorta.

Through the largest artery of the body, liquid connective tissue moves throughout the body, providing structures with useful substances and oxygen.

The defeat of the fraction leads to a proportional decrease in trophism (nutrition). This means functional disorders. All systems are affected. The heart itself, kidneys, liver, digestive tract as a whole, brain. The clinical picture does not develop overnight.

Cardiac

It all starts with the actual cardiac symptoms:

Chest pain. Localization may be confusing. Somewhere in the center or slightly to the left. There are known cases of detection of discomfort in the peritoneum, epigastric region.

A characteristic feature of cardiovascular pain is burning, pressure, bursting and recoil in the arm, scapula, jaw and teeth.

At first, the unpleasant sensation is minimal, it appears periodically. For a few seconds. Progression leads to an aggravation of the condition. The duration of the episodes increases, and the intensity of the pain also becomes higher.

Cupping is possible with Nitroglycerin, but with caution. The critically low ejection fraction (less than 40%) requires precise dosage adjustment. Possible decreased contractility, cardiac arrest and death of the patient.

Dyspnea. Violation of the natural process. It occurs as a result of insufficient gas exchange. In this case, a small circle of blood circulation is already involved.

The restoration of normal activity is possible in the early stages, then the symptom haunts the person constantly. At first, it occurs only after excessive physical exertion. Then at rest.

The manifestation is difficult for the patient. Including psychologically, since normal rest becomes impossible. We have to put the pillow higher, awakenings are frequent.

Arrhythmia. By type, as a result of artificial stimulation of the natural driver. Then and.

These are already dangerous varieties that can lead to the death of the patient. According to statistics, it is heart rate disorders that cause death in 15-20% of cases among all recorded clinical situations.

Weakness, drowsiness, decreased ability to work, even perform daily duties. It is united by the name of asthenia. Leads to constant fatigue, then to mental disorders.
Violation of the mental plan. Typically, patients with low ejection fraction in the medium term suffer from depression, anxiety disorders.

Attachment of angina pectoris causes panic episodes, with a feeling of intense fear. Most of the time, the patient is inactive, lethargic, apathetic. The reason must be sought. Classic mental disorders manifest themselves in the same way.

Cyanosis of the skin. Paleness all over the body. Also mucous membranes. The manifestation is especially clearly visible when examining the gums.

Cerebral

Then moments from the side of the brain are added:

Headache. It develops suddenly, a clear localization is not determined, except in rare cases. Then the back of the head and the parietal region are involved.

By its nature, the discomfort is pressing, bale, intensifies and pulsates in time with the beating of the heart. It is removed with analgesics like Novigan.

The sensation has a vascular origin, therefore it is dangerous to form a stroke with illiterate actions. When developing, it is recommended to consult a cardiologist, since this is a relatively late manifestation.

Dizziness. Vertigo. Accompanied by an inability to navigate normally in space. The patient takes a forced position. Usually lying down. The episodes last up to several hours.
Nausea and vomiting. Previous manifestations complement each other. Even emptying the stomach does not relieve the condition. Because we are talking about a reflex phenomenon. The body is not cleansed, no correction occurs.
Loss of consciousness. Syncope conditions. Fainting is rare; as the ejection fraction progresses, it becomes more frequent and deeper. This is an unfavorable sign. He talks about the imminent possible onset of a stroke. Urgent help is required.
Sleep disturbances. By the type of frequent night awakenings for no apparent reason. Vegetative manifestations are possible: increased sweating, tachycardia, anxiety. This continues several times during one episode.
Visual impairment. The appearance of fog, flies, photopsies (flashes).

From other bodies

With a prolonged course of the pathological process with a decrease in the ejection fraction, other manifestations from the organs of the digestive tract, excretory system are added:

Drop in body weight. Sudden and unrelated to dieting. It occurs in response to a long-term violation of tissue trophism. Differential diagnosis with hormonal and tumor pathologies is required.
Constipation and diarrhea. Alternating one with the other. The instability of the stool is associated with unstable intestinal motility, disorders of the digestive process.
An increase in the size of the liver. Secondary or even tertiary hepatitis. The organ protrudes from under the edge of the costal arch, is palpable and visible on ultrasound.
Hence the accumulation of fluid in the abdominal cavity (ascites), obstructive jaundice due to the release of bilirubin into the blood, which stains the tissues and sclera of the eyes.
Abdominal pain of unknown etiology.
Admixture of blood to feces. Fresh. Differential diagnosis with hemorrhoids is required. If black veins are found - with colorectal cancer.
Peripheral edema. As a result of a drop in myocardial contractility. At first, the process covers only the ankles, then rises higher.

The signs are nonspecific. But when evaluated in a complex, they indicate heart problems.

Causes of decreased ejection fraction

Violation of the normal level of the ejection fraction develops as a result of the actual cardiac pathologies especially often.

There are a lot of options in this case. From hypertension, which was not treated on time before a heart attack, recently transferred (EF falls as a result of the formation of cardiosclerosis), angina pectoris and arrhythmias with a decrease in contractility.

Any disease of a muscular organ can lead to a deviation of the indicator.

Another option is vascular pathology. Vasculitis, aneurysms, others. Autoimmune or infectious origin.

Also hormonal diseases with a decrease in the concentration of substances of the pituitary gland, adrenal glands or thyroid gland. Diabetes.

Intoxication with alcohol, drugs, heavy metal salts and other toxic substances.

Excessive physical activity becomes the main reason for increased EF. If the output is reduced, it leads to a weakening of hemodynamics (blood flow). Such a process is considered threatening..

As for the opposite phenomenon (EF is higher than normal), it does not play a large clinical role and is rarely stable.

Diagnostics

Performed when at least one symptom or warning sign is present.

Decreased ejection fraction is not an independent disease. Such a name cannot be found in the international classifier.

This is an instrumental sign, a functional indicator that is used to state the fact of a decrease in myocardial contractility. What is behind the deviation is a question.

It is solved by diagnostic methods:

Oral questioning of the patient. To objectify complaints, to identify a complete clinical picture.
The collection of anamnesis serves the same purposes. Allows you to name the likely cause of the pathological process.
Measurement of blood pressure. Most often it is normal until a certain point. Decreases in proportion to the progression of the disorder.
Heart rate is also examined. For these purposes, a routine calculation of the number of beats per minute is carried out, as well as electrocardiography.

ECG provides information on the presence of arrhythmias, their nature and degree. It can be carried out during the day using a special Holter monitor.

This is an even more thorough study. Evaluates vital signs over the course of 24 hours, in dynamics.

Echocardiography. The key technique for detecting functional impairment. The norm of the ejection fraction of the heart is not a basis for stopping the diagnosis, other pathologies are possible if there are complaints.

In the automatic mode, the percentage is calculated, then the doctor concludes that the indicator is normal in a particular patient.

The problem is that right off the bat to say that it is within the limits of what is permissible, that is not impossible. It is necessary to observe a person for at least a few days, sometimes weeks.

Therefore, it is preferable to lead the patient in a cardiological hospital.

Blood test for hormones (thyroid, pituitary, adrenal glands), general, biochemical. They can provide a lot of information.
MRI according to indications. Consider the anatomical properties of the heart more carefully. To say whether defects, irreversible changes in the myocardium have formed against the background of functional impairment.

Additionally, you may need to consult a neurologist. When problems with the brain are detected, cerebral symptoms join.

Routine reflex examinations can assess the nature of the induced disorder and take action.

Treatment

Therapy is conservative, surgical methods can be helped only if the reason for the decrease in the ejection fraction lies in heart disease.

First, you need to carefully assess the patient's condition, confirm that it has a disease-causing origin. This is indicated by the instability of numbers, poor health. Symptoms are always present at least to a minimum.

Pathology itself cannot be cured. It is necessary to eliminate the root cause. There are many of them and not always of cardiac origin.

Shown are detoxification (in case of poisoning), the use of hormonal replacement drugs (endocrine disorders), relief of septic or autoimmune inflammation (vasculitis, vascular lesions and the heart itself).

Antihypertensive treatment is prescribed to persons with consistently high blood pressure levels until the condition is corrected. Of the medicines, ACE inhibitors, calcium antagonists and others are used most actively.

To maintain the work of the muscular organ itself, the following drugs are prescribed:

Cardioprotectors. Riboxin or Mildronate.
Antiarrhythmic. With pronounced violations of heart rate. Amiodarone, Quinidine, less often others.
Beta blockers. Anaprilin, Carvedilol. To relieve tachycardia and partially lower blood pressure.
Antiplatelet agents. Heparin, Aspirin-Cardio. Prevents blood clots.
Nitroglycerin, if permitted. To improve contractility, restore normal organ function, eliminate pain in the acute period.

Folk remedies are strictly prohibited. It is recommended to give up smoking, alcohol, any medications that are not directly prescribed by a specialist, sleep for at least 7 hours, walk in the fresh air, and consume less fat.

It is better to clarify questions of restrictions with the doctor, since it is not known in what initial position the patient was.

Forecast

Mainly favorable for early detection. The likelihood of a quality life and just the continuation of biological existence fall in proportion to the progression of the process.

With proper therapy in the early and middle stages (if the left ventricular ejection fraction is at least 40%), the percentage of deaths is determined at 15%. It happens a little more. In the later stages, 40-60% and more.

A complete correction will never be achieved. The process has already begun, organic disorders in the myocardium are proceeding, there is nowhere to put them.

However, it is possible to compensate for the situation, although the treatment is likely to continue for many years, if not a lifetime. It's not a big price to pay.

Possible complications

The main thing among others is cardiac arrest as a result of further malnutrition and a decrease in myocardial contractility.

Another clinically common option is myocardial infarction. As a result of the small volume of nutrient supply through the coronary arteries to the heart itself. Leads to death or disability. Exacerbates pathological abnormalities even more.

Stroke. Acute weakening of the nutrition of the brain. It is considered the probable end of cerebral ischemia. As soon as there are disturbances from the work of the nervous system, such as dizziness, nausea, fainting, you need to run as fast as you can to the doctor to correct the condition and prevent a potentially fatal phenomenon.

Vascular dementia. It is possible with a prolonged course of the violation. Pulmonary edema, cardiac asthma. Also emergency conditions. They carry a great danger to life. Are fraught with asphyxia.

Most often, this process ends in death or death. But he himself is not the culprit of the dire consequences. This is just a result, a syndrome. You need to look for the underlying cause, the primary disease.

The drop in the ejection fraction is the result of insufficient myocardial contractility. Leads to generalized dysfunction of all organs. Ultimately - to the death of the patient.

Such a sad scenario can be prevented. But you should contact a cardiologist in time to prescribe a course of therapy.

To assess the work of a continuously working human "motor", many quantitative indicators are taken into account. Among them are the ejection of the heart (BC) and the ejection fraction of the heart (FVF).

The norm of these values and comparison with them of the values measured in a particular patient, allow the doctor to get an objective idea of the functional reserves of the "pumping" function of the myocardium and the existing pathologies in his cardiovascular system.

The information, photos and videos in this article will help the layman understand the essence of these parameters, how they are measured, what affects the VV and FVS indicators, and whether modern medicine can affect the body to normalize these values.

Cardiac output is the total volume of blood flowing from the heart into the great vessels over a certain period of time or the volumetric blood flow velocity. Usually, the time unit is equal to 1 minute, therefore, among physicians, the term "minute volume of blood circulation" or its abbreviation "IOC" is often used.

Factors affecting the value of the cardiac output

Cardiac output depends on:

age and anthropometric indicators;
human states - rest (preload), after physical exertion, psycho-emotional background;
the frequency of myocardial contractions and its qualitative characteristics - stroke or systolic blood volume (CBC), entering the left ventricle into the aorta, and from the right ventricle into the pulmonary artery, during their contraction;
the value of "venous return" - the blood volume flowing into the right atrium from the superior and inferior vena cava, which collects blood from the whole body;
the dimensions of the thickness of the muscle wall and the volume of the heart chambers (see in the figure above).

For your information. The VS parameter is also influenced by the specific indicators of the pumping (contractile) ability of the cardiac apparatus and the current state of the total resistance to the blood flow of the system of peripheral blood vessels of the general circulation.

Reference values and standard assessment parameters

Today, it is quite easy to find out the exact indicators of cardiac hemodynamics. Most of them are calculated by a computer program during a non-invasive echocardiographic ultrasound examination.

The procedure can be done for free in a public clinic, performed by a private medical institution or laboratory, and even called a specialist with a portable device at home. The cost of the examination ranges from 700 to 6,500 rubles, and depends on the class of equipment.

There are other methods for determining the VS and SHS - according to Fick, thermodilution, left ventriculography, Starr's formula. Their implementation is invasive, therefore they are used in cardiac surgery. The description of their essence will be clear only to specialists, and for the layman we will clarify that they are intended to monitor the state of the cardiovascular system during operations, monitor the patient's condition in intensive care, but some are sometimes performed to make an accurate diagnosis.

Whatever methods of measuring VV are used, its reference values in a healthy adult who is in physical rest and psychoemotional balance are fixed in the range from 4 to 6 L / min, while in one contraction from the left ventricle into the aorta, from 60 to 100 ml of blood. Such indicators are considered optimal, provided that the heart was beating at a rate of 60-90 beats / min, the upper pressure was in the range from 105 to 155, and the lower pressure was from 55 to 95 mm Hg. Art.

On a note. Unfortunately, echocardiography is not always enough to clarify the cardiological diagnosis. In addition to it, the doctor may prescribe CT imaging, PhonoKG, EFI, CT coronary angiography, radionuclide diagnostics.

Cardiac Output Syndromes

A decrease in VS occurs due to a decrease in the speed and volume of the "venous outflow", as well as a violation of the contractility of the myocardium.

The causes of small cardiac output syndrome include:

Diseases or conditions caused by cardiac origin or complications after cardiac surgery:
1. bradyarrhythmia, tachyarrhythmia;
2. heart valve defects;
3. terminal stage of congestive heart failure;
4. metabolic disorder in the myocardium;
5. occlusion of a shunt or great vessel;
6. decrease in blood volume;
7. accumulation of air in the pleural cavity and compression of the lobes of the lungs;
8. accumulation of fluid between the sheets of the pericardium;
9. oxygen starvation of the myocardium;
10. a shift in the acid-base balance of the body towards an increase in acidity (decrease in pH);
11. sepsis;
12. cardiogenic shock.
Noncardiac processes:
1. massive blood loss;
2. extensive burn;
3. decreased nerve stimulation of the heart;
4. sudden varicose veins;
5. obstruction of large veins;
6. anemia;
7. carbon dioxide poisoning.

On a note. Aging of the body, prolonged physical inactivity, starvation, diets that lead to a decrease in skeletal muscle volume, cause a persistent low cardiac output syndrome.

High VS is an adequate reaction of the heart in response to physical or psycho-emotional stress. The heart of a marathon athlete is able to work at the maximum limit - with an increase in venous return and cardiac output by 2.5 times, pumping up to 40 liters per minute.

If the VS indicator is increased at rest, then this may be a consequence of:

the initial stage of cardiac wall hypertrophy - "athlete's heart";
thyrotoxicosis;
arteriovenous fistulas;
chronic mitral and aortic regurgitation with left ventricular overload;
low hemoglobin;
beriberi disease (vitamin B1 deficiency);
pathology of Paget (deforming osteodystrophy).

For your information. An increase in the load on the cardiovascular system during pregnancy causes an increase in VS, which after childbirth returns to normal by itself.

What is heart ejection fraction

Among the criteria characterizing cardiac hemodynamics, one can find more "complex" parameters. Among them, the Cardiac Ejection Fraction (EFF), which is the percentage of the stroke systolic blood volume expelled from the left ventricle during contraction of the heart to the volume of blood accumulated in it by the end of the period of relaxation of the heart muscle (diastole).

This indicator is used to predict any cardiovascular pathology.

Reference values

The norm of the Left ventricular ejection fraction at rest is 47-75%, and with psychoemotional and physical exertion, its value can reach 85%. In old age, the indicator decreases slightly. In children, the reference values at rest are higher - 60-80%.

The FVS value is determined during radionuclide angiography using the formulas of Simpson or Teicholz. The survey form indicates which formula was applied, as there may be discrepancies within 10%.

Cardiologists pay attention to FVS in cases when it drops to 45% and below. Such values are a clinical symptom of impaired contractile insufficiency and a decrease in the efficiency of the heart muscle. Indicators below 35% indicate irreversible processes in the myocardium.

For your information. At the initial stage of any cardiac disease, the rate of emission of the heart fraction does not change due to adaptive processes - thickening of muscle tissue, restructuring of small-diameter vessels and alveoli, an increase in strength and / or the number of contractions. The change in the FVS value occurs when the compensations are exhausted.

Reasons for the decline

A low cardiac output fraction occurs due to:

diseases, infectious and inflammatory processes and myocardial defects;
heavy load on the heart as a result of pulmonary hypertension;
pathology of the coronary and pulmonary vessels;
tumor formations and diseases of the thyroid and pancreas, adrenal glands;
diabetes mellitus, obesity;
poisoning with alcohol, tobacco, drugs,.

Attention! Increasingly, cases of a decrease in the contractile work of the myocardium are recorded in young and mature people who abuse energy drinks.

Symptoms

Despite the fact that a low cardiac output fraction is itself a clinical symptom, it has its own characteristic manifestations:

increased breathing rate, asthma attacks are possible;
light-headedness and fainting;
"Flies" or "darkening" in the eyes;
an increase in heart rate to the values of tachycardia;
swelling of the lower extremities (feet, legs);
numbness of hands and feet;
a smooth increase in the size of the liver;
pain syndrome (of different nature and strength) in the heart and abdomen.

Important! Often, people suffering from diseases that are accompanied by a low ejection fraction of the heart look like drunk. Their coordination of movement is impaired, a wobbly gait becomes, the tongue becomes braided and other speech defects appear.

How to increase the ejection fraction of the heart

Treatment of a low ejection fraction of the heart is aimed at stabilizing pathological processes, and occurs within the framework of standard therapy for a disease or condition that caused a decrease in myocardial performance and correction of left ventricular failure. In addition to hypertensive drugs, blood thinners, anticoagulants, statins, peripheral vasodilators, antiarrhythmics, aldosterone and angiotensin 2 receptor antagonists can be prescribed.

If the cardiac output fraction indicator falls below 35%, treatment measures are aimed at improving the quality of life. If necessary, resynchronization therapy (artificial blockade) is performed. In cases of arrhythmias that threaten lethal outcome, a pacemaker or cardiovascular defibrillator is placed.

And at the end of the article, watch a video with detailed instructions on how to perform exercises from Chinese health-improving gymnastics that are available to everyone, which will help improve the cardiovascular system at an energy level.

Patients who have received a referral for medical diagnostics of the heart and blood vessels meet such a concept as the ejection fraction. It is measured by ultrasound, contrast X-ray and echocardiography.

In this article, the reader will get acquainted with the definition of "cardiac output", norms and interpretation, and also learn about methods of treatment and prevention.

If you have any questions, you can contact the specialists of the portal.

Competent consultations are provided free of charge 24 hours a day.

The ejection fraction is an indicator that determines the efficiency of the muscles of the heart organ at the time of impact. It is measured as a percentage of the volume of blood entering the vessels in a state of ventricular systole. For example, in the presence of 100 ml, 65 ml enters the vascular system, thus the cardiac output will be equal to 65%.

Basically, measurements are taken of the left ventricle, since from it the blood enters the circulation in a large circle. If there is a lack of blood in this ventricle, then this becomes the cause of heart failure, which leads to the development of organ diseases.

The ejection fraction is not prescribed for all patients, but only for those who complain about:

pain in the chest;
systematic interruptions in the work of the body;
tachycardia;
dyspnea;
frequent dizziness and fainting;
swelling of the lower extremities;
rapid fatigue and weakness;
decreased productivity.

Typically, the first test is an electrocardiogram and ultrasound. These examinations allow you to find out to what extent cardiac output occurs in both the left ventricle and the right. Diagnostics is notable for its low cost, high information content, and there is no specific training. The availability of the procedure is due to the fact that any ultrasound equipment is capable of providing data on the fraction.

Normal fraction ejection

The human heart, even without external stimuli, continues to work, expelling over 50% of the blood in each systolic state. If this indicator begins to decline to a level of less than 50%, then failure is diagnosed. As a result of a decrease in volume, the myocardium develops, ischemia, defect, etc.

The ejection fraction varies in the range of 55-70 percent - this is the norm. Decrease to 35-40 percent mark entails dangerous interruptions. To prevent a fatal fall, it is necessary to visit a cardiologist at least once a year. For persons over the age of 40 - this is a mandatory procedure. The symptomatic picture described above is a sure reason for contacting a qualified cardiologist.

Cardiac output when diagnosing the body of a patient with pathologies in the cardiovascular system, an important priority is to determine the individual minimum threshold. Based on the information, the doctor can diagnose and prescribe the correct therapy.

Ultrasound - norms and decoding

At the end of the ultrasound examination, the diagnostician draws up a protocol, where he enters all the data obtained about the state of the left ventricle. Subsequently, the information is decrypted. When pathologies are identified, the doctor explains the results obtained and a diagnosis is made.

Even without a medical education, a person can independently decipher the main indicators and see the clinical picture of the examined organ. Decryption occurs by comparing the information received with the norm table.

ejection fraction, range: 55 -60%;
the size of the atrium of the right chamber: 2.7-4.5 cm;
stroke volume: 60-100 ml;
aortic diameter: 2.1-4.1 cm;
diastolic wall thickness: 0.75-1.1 cm;
systole size: 3.1-4.3 cm;
left chamber atrial size: 1.9 to 4 cm.

The above indicators must be considered in aggregate. Deviation from the norm of one is not a suspicion of a pathological process, however, it may require additional diagnostics.

On the portal you can download for free:

How to heal a low faction level?

With information about the rate of cardiac output, the reader can analyze the performance of the organ. When left ventricular ejection is below normal, it is recommended to consult a cardiologist as soon as possible. It is worth noting that the doctor is primarily interested not in the presence of pathology, but in the cause of the development of the disease. Therefore, after ultrasound, additional studies are often carried out.

Low ventricular ejection is most commonly associated with feeling unwell, swelling, and shortness of breath. How to increase the size of the fraction? We live in the era of progressive medicine, therefore, in the arsenal of doctors to increase the release of blood into the vessels, therapy takes the first place. Basically, the ward is on outpatient treatment, during which specialists monitor the activity of the heart and vascular system. In addition to medication, surgery is sometimes performed.

fluid intake is strictly regulated and amounts to 1.5-2 liters of water per day;
refusal from salt, seasonings and dishes containing it;
dietary diet;
moderate physical activity;
taking medications: urinary tract stimulants, inhibitors, adrenaline blockers, digoxin, etc.

The blood supply can be restored surgically. As a rule, operations are prescribed for patients who have been diagnosed with severe heart disease or valvular disease. Often, the valves are resected and prostheses are inserted. This approach allows you to normalize the heart rate, eliminate arrhythmia and fibrillation. It should be noted that operations are carried out if there is a high danger to human life. In all other cases, therapy is carried out.

Preventive methods

In the absence of a genetic predisposition to diseases of the cardiovascular system, the fraction can be kept normal without difficulty.

daily exercise;
eating foods saturated with iron;
do not abuse alcoholic beverages and tobacco;
follow a healthy regimen;
Do aerobics 2-3 times a week;
choose foods with low salt levels.

The main key is aerobics. There is an opinion that physical activity is harmful for diseases of the heart and blood vessels. It is a myth.

Only lifting weights can bring harm, i.e. a gym for the sick is prohibited. On the contrary, aerobic exercise strengthens the walls of blood vessels and does not overload the heart. Such exercises improve muscle function by removing oxygen from the blood. It is necessary to engage in gradually increasing the load.

According to statistics from the 20th century, elderly people most often suffered from cardiovascular diseases. Today, this has also affected the younger generation. The main risk group includes residents of megacities, who suffer from low levels of clean air and exhaust gases. Therefore, it is very important for every person to undergo a medical examination annually, not only by a cardiologist, but also by other doctors. Remember that only you are responsible for your health!

In this article, the reader will get acquainted with the definition of "cardiac output", norms and interpretation, and also learn about methods of treatment and prevention.

If you have any questions, you can contact the specialists of the portal.

Competent consultations are provided free of charge 24 hours a day.

Concepts and symptoms

Basically, measurements are taken of the left ventricle, since from it the blood enters the circulation in a large circle. If there is a lack of blood in this ventricle, then this becomes the cause of heart failure, which leads to the development of organ diseases.

The ejection fraction is not prescribed for all patients, but only for those who complain about:

pain in the chest;
systematic interruptions in the work of the body;
tachycardia;
dyspnea;
frequent dizziness and fainting;
swelling of the lower extremities;
rapid fatigue and weakness;
decreased productivity.

Normal fraction ejection

Ultrasound - norms and decoding

ejection fraction, range: 55 -60%;
the size of the atrium of the right chamber: 2.7-4.5 cm;
stroke volume: 60-100 ml;
aortic diameter: 2.1-4.1 cm;
diastolic wall thickness: 0.75-1.1 cm;
systole size: 3.1-4.3 cm;
left chamber atrial size: 1.9 to 4 cm.

The above indicators must be considered in aggregate. Deviation from the norm of one is not a suspicion of a pathological process, however, it may require additional diagnostics.

On the portal you can download for free:

How to heal a low faction level?

fluid intake is strictly regulated and amounts to 1.5-2 liters of water per day;
refusal from salt, seasonings and dishes containing it;
dietary diet;
moderate physical activity;
taking medications: urinary tract stimulants, inhibitors, adrenaline blockers, digoxin, etc.

Preventive methods

In the absence of a genetic predisposition to diseases of the cardiovascular system, the fraction can be kept normal without difficulty.

daily exercise;
eating foods saturated with iron;
do not abuse alcoholic beverages and tobacco;
follow a healthy regimen;
Do aerobics 2-3 times a week;
choose foods with low salt levels.

The main key is aerobics. There is an opinion that physical activity is harmful for diseases of the heart and blood vessels. It is a myth.

cardiologiya.com

If you have already undergone an ultrasound examination of the kidneys or, for example, the abdominal organs, then you remember that in order to roughly decipher their results, most often you do not have to go to the doctor - you can find out basic information before visiting the doctor, when you read the conclusion yourself. The results of an ultrasound of the heart are not so easy to understand, so it can be difficult to unravel them, especially if you disassemble each indicator by number.

You can, of course, just look at the last lines of the form, where the general summary of the study is written, but this also does not always clarify the situation. So that you can better understand the results obtained, we present the basic norms of ultrasound of the heart and possible pathological changes that can be established by this method.

Norms in ultrasound for heart chambers

To begin with, here are a few numbers that are necessarily found in every Doppler echocardiography report. They reflect various parameters of the structure and function of individual chambers of the heart. If you are a pedant and take a responsible approach to decrypting your data, pay maximum attention to this section. Perhaps, here you will find the most detailed information in comparison with other Internet sources intended for a wide range of readers. Data may differ slightly from one source to another; here are the figures based on the materials of the manual "Norms in Medicine" (Moscow, 2001).

Left ventricular parameters

Left ventricular myocardium mass: men - 135-182 g, women - 95-141 g.

Left ventricular myocardial mass index (often referred to as LVMI on the form): men 71-94 g / m2, women 71-89 g / m2.

End-diastolic volume (EDV) of the left ventricle (the volume of the ventricle that it has at rest): men - 112 ± 27 (65-193) ml, women 89 ± 20 (59-136) ml

End-diastolic size (EDR) of the left ventricle(the size of the ventricle in centimeters that it has at rest): 4.6 - 5.7 cm

End systolic dimension (ESR) of the left ventricle(the size of the ventricle during contraction): 3.1 - 4.3 cm

Wall thickness in diastole(outside of heartbeats): 1.1 cm

With hypertrophy - an increase in the thickness of the ventricular wall due to too much stress on the heart - this indicator increases. Figures 1.2 - 1.4 cm indicate a slight hypertrophy, 1.4-1.6 - about an average, 1.6-2.0 - about a significant, and a value of more than 2 cm indicates a high degree of hypertrophy.

Ejection fraction (EF): 55-60%.

At rest, the ventricles fill with blood, which is not completely expelled from them during contractions (systole). The ejection fraction shows how much blood in relation to its total amount the heart ejects with each contraction, normally it is slightly more than half. With a decrease in the EF, they speak of heart failure, which means that the organ is not efficiently pumping blood, and it can stagnate.

Impact volume(the amount of blood that is ejected by the left ventricle in one contraction): 60-100 ml.

Right ventricular parameters

Wall thickness: 5 ml

Size index 0.75-1.25 cm / m2

Diastolic size (size at rest) 0.95-2.05 cm

Ventricular septum parameters

Resting thickness (diastolic thickness): 0.75-1.1 cm

Excursion (moving from side to side during heart contractions): 0.5-0.95 cm. An increase in this indicator is observed, for example, with some heart defects.

Right atrial parameters

For this chamber of the heart, only the value of the EDV is determined - the volume at rest. A value of less than 20 ml indicates a decrease in EDV, a value of more than 100 ml indicates an increase, and EDV of more than 300 ml occurs with a very significant increase in the right atrium.

Left atrial parameters

Size: 1.85-3.3cm

Size index: 1.45 - 2.9 cm / m2.

Most likely, even a very detailed study of the parameters of the heart chambers will not give you particularly clear answers to the question of your health. You can simply compare your indicators with the optimal ones and, on this basis, draw preliminary conclusions about whether everything is generally normal for you. For more information, contact a specialist; the volume of this article is too small for broader coverage.

Norms in ultrasound for heart valves

With regard to deciphering the results of the examination of the valves, then it should be a simpler task. You just need to look at the general conclusion about their condition. There are only two main, most frequent pathological processes: stenosis and valve insufficiency.

The term "stenosis" a narrowing of the valve opening is indicated, in which the above-lying chamber of the heart hardly pumps blood through it and may undergo hypertrophy, which we talked about in the previous section.

Failure Is the opposite state. If the valve flaps, which normally prevent the reverse flow of blood, for some reason cease to perform their functions, the blood that has passed from one chamber of the heart to another partially returns back, reducing the efficiency of the organ.

Depending on the severity of the disorders, stenosis and insufficiency can be 1.2 or 3 degrees. The higher the degree, the more serious the pathology.

Sometimes in the conclusion of an ultrasound of the heart, you can find such a definition as "relative failure". In this condition, the valve itself remains normal, and blood flow disturbances occur due to the fact that pathological changes occur in the adjacent chambers of the heart.

Norms in ultrasound for the pericardium

The pericardium, or bursa pericardium, is the “sac” that surrounds the outside of the heart. It grows together with the organ in the area of vascular discharge, in its upper part, and between it and the heart itself there is a slit-like cavity.

The most common pathology of the pericardium is inflammation, or pericarditis. With pericarditis, adhesions and fluid accumulate between the sac and the heart. Normally, it is 10-30 ml, 100 ml indicates a small accumulation, and over 500 - a significant accumulation of fluid, which can lead to difficulty in the full functioning of the heart and its squeezing ...

To master the specialty of a cardiologist, a person must first study at a university for 6 years, and then study cardiology separately for at least a year. A qualified doctor has all the necessary knowledge, thanks to which he can not only easily decipher the conclusion to the ultrasound of the heart, but also make a diagnosis and prescribe treatment based on it. For this reason, the interpretation of the results of such a complex study as ECHO-cardiography should be provided to a specialized specialist, and not try to do it on your own, long and unsuccessfully “poking around” in numbers and trying to understand what these or those indicators mean. This will save you a lot of time and nerves, since you will not have to worry about your probably disappointing and, even more likely, wrong conclusions about your state of health.

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PV rate

To assess the work of the heart, namely the left ventricle, the Teicholz or Simpson formulas are used. It must be said that it is from this department that the blood enters the general circulation and with left ventricular failure, the clinical picture of heart failure most often develops.

The closer this indicator is to the norm, the better the main "motor" of the body is reduced and the more favorable the prediction for life and health. If the obtained value is much lacking to the norm, then it can be concluded that the internal organs do not receive the required amount of oxygen and nutrients from the blood, which means that the heart muscle must be somehow supported.

The calculation is carried out directly on the equipment on which the patient is examined. In modern rooms for ultrasound diagnostics, preference is given to the Simpson method, which is considered more accurate, although the Teicholz formula is used no less often. The results of both methods can vary by up to 10%.

Ideally, the ejection fraction should be 50-60%. According to Simpson, the lower bound is 45%, and according to Teicholz, 55%. Both methods are distinguished by a fairly high level of information content regarding the myocardial contraction capabilities. If the obtained value fluctuates between 35-40%, they speak of advanced heart failure. And even lower rates are fraught with fatal consequences.

Causes of EF decrease

Low values can be caused by pathologies such as:

Cardiac ischemia. In this case, the blood flow through the coronary arteries decreases.
History of myocardial infarction. This leads to the replacement of normal heart muscles with scars, which do not have the necessary ability to contract.
Arrhythmia, tachycardia and other ailments that disrupt the rhythm of the body's main "motor" and conduction.
Cardiomyopathy. It consists in an increase or lengthening of the heart muscle, which is caused by hormonal failure, prolonged hypertension, heart defects.

Symptoms of the disease

A diagnosis of decreased ejection fraction can be made based on symptoms specific to the disease. Such patients often complain of attacks of shortness of breath, both during physical exertion and at rest. Breathlessness can be triggered by prolonged walking, as well as performing the simplest chores around the house: washing floors, cooking.

In the process of impaired blood circulation, fluid retention occurs, which leads to the appearance of edema, and in severe cases, they affect internal organs and tissues. A person begins to suffer from abdominal pain on the right side, and stagnation of venous blood in the vessels of the liver can be fraught with cirrhosis.

These symptoms are characteristic for a decrease in the contractile function of the main "motor" of the body, but it often happens that the level of the ejection fraction remains normal, so it is very important to be examined at least once a year and do echocardioscopy, especially for people with heart disease.

An increase in EF to 70–80% should also be alarming, since this may be a sign that the heart muscle cannot compensate for the growing heart failure and tends to throw as much blood as possible into the aorta.

As the disease progresses, the LV function will decrease, and it is echocardioscopy in dynamics that will allow you to catch this moment. A high ejection fraction is typical for healthy people, in particular, athletes in whom the heart muscle is sufficiently trained and is able to contract with greater force than that of an ordinary person.

Treatment

It is possible to increase the reduced EF. For this, doctors use not only drug therapy, but also other methods:

Prescribe drugs to improve myocardial contractility. These include cardiac glycosides, after which there is a noticeable improvement.
To prevent overloading the heart with excess fluid, they are encouraged to follow a diet with restriction of table salt to 1.5 g per day and fluid intake to 1.5 liters per day. Along with this, diuretic drugs are prescribed.
Prescribe the intake of organoprotective agents that help protect the heart and blood vessels.
Make a decision about a surgical operation. For example, valve replacement is performed, shunts are installed on coronary vessels, etc. However, an extremely low ejection fraction may become a contraindication to surgery.

Prophylaxis

Prevention to prevent the development of heart disease is of great importance, especially in children. In the age of high technologies, when most of the work is performed by machines, as well as the constantly deteriorating environmental conditions of life and improper nutrition, the risk of developing heart ailments increases significantly.

Therefore, it is very important to eat right, play sports, and be outdoors more often. It is this lifestyle that will ensure the normal contractility of the heart and muscle fitness.

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The amount of blood ejected by the ventricle of the heart in an artery per minute is an important indicator of the functional state of the cardiovascular system (CVS) and is called minute volume blood (IOC). It is the same for both ventricles and at rest is 4.5–5 liters.

An important characteristic of the pumping function of the heart is given by stroke volume also called systolic volume or systolic ejection . Impact volume- the amount of blood ejected by the ventricle of the heart into the arterial system in one systole. (If we divide the IOC by the heart rate per minute, we get systolic volume (CO) of blood flow.) With a heart contraction equal to 75 beats per minute, it is 65–70 ml, during work it increases to 125 ml. In athletes at rest, it is 100 ml, during work it increases to 180 ml. Determination of IOC and CO is widely used in the clinic.

Ejection fraction (EF) - the ratio of the stroke volume of the heart to the end-diastolic volume of the ventricle, expressed as a percentage. EF at rest in a healthy person is 50-75%, and during physical activity it can reach 80%.

The volume of blood in the ventricular cavity, which it occupies before its systole, is end-diastolic volume (120-130 ml).

End-systolic volume (CSR) is the amount of blood remaining in the ventricle immediately after systole. At rest, it is less than 50% of the EDV, or 50-60 ml. Part of this blood volume is reserve volume.

The reserve volume is realized with an increase in CO under loads. Normally, it is 15-20% of the end-diastolic.

The volume of blood in the cavities of the heart, remaining with the full implementation of the reserve volume, at maximum systole is residual volume. CO and IOC values are not constant. With muscular activity, the IOC increases to 30–38 liters due to an increase in heart rate and an increase in MOC.

A number of indicators are used to assess the contractility of the heart muscle. These include: ejection fraction, the rate of expulsion of blood in the rapid filling phase, the rate of increase in pressure in the ventricle during the period of tension (measured during ventricular probing) /

Blood expulsion rate changes by the Doppler method with ultrasound of the heart.

Pressure rise rate in the cavities, the ventricles are considered one of the most reliable indicators of myocardial contractility. For the left ventricle, the value of this indicator is normally 2000-2500 mm Hg / s.

A decrease in the ejection fraction below 50%, a decrease in the rate of expulsion of blood, the rate of increase in pressure indicate a decrease in myocardial contractility and the possibility of developing insufficiency of the pumping function of the heart.

The value of the MOC divided by the surface area of the body in m 2 is determined as cardiac index(l / min / m 2).

SI = MOK / S (L / min × m 2)

It is an indicator of the pumping function of the heart. Normal cardiac index is 3-4 l / min × m 2.

IOC, UOC and SI are united by a common concept cardiac output.

If the IOC and blood pressure in the aorta (or pulmonary artery) are known, it is possible to determine the external work of the heart

P = MOK × HELL

P is the work of the heart in minutes in kilogram (kg / m).

IOC - minute blood volume (l).

BP - pressure in meters of water column.

During physical rest, the external work of the heart is 70-110 J, during work it increases to 800 J, for each ventricle separately.

Thus, the work of the heart is determined by 2 factors:

1. The amount of blood flowing to it.

2. Vascular resistance during the expulsion of blood in the arteries (aorta and pulmonary artery). When the heart cannot pump all the blood into the arteries for a given vascular resistance, heart failure occurs.

There are 3 types of heart failure:

1. Failure from overload, when excessive demands are made on the heart with normal contractility in case of defects, hypertension.

2. Heart failure in case of myocardial damage: infection, intoxication, vitamin deficiency, impaired coronary circulation. At the same time, the contractile function of the heart decreases.

3. Mixed form of insufficiency - with rheumatism, degenerative changes in the myocardium, etc.

The whole complex of manifestations of heart activity is recorded using various physiological methods - cardiography: ECG, electrocymography, ballistocardiography, dynamocardiography, apical cardiography, ultrasound cardiography, etc.

The diagnostic method for the clinic is the electrical registration of the movement of the contour of the heart shadow on the screen of the X-ray machine. A photocell connected to an oscilloscope is applied to the screen at the edges of the heart contour. With the movements of the heart, the illumination of the photocell changes. This is recorded by an oscilloscope in the form of a curve of contraction and relaxation of the heart. This technique is called electrokymography.

Apical cardiogram registered by any system that captures small local movements. The sensor is reinforced in the 5th intercostal space above the place of the heart beat. It characterizes all phases of the cardiac cycle. But it is not always possible to register all the phases: the cardiac impulse is projected in different ways, part of the force is applied to the ribs. The recording may differ from person to person and from one person to another, the degree of development of the fat layer, etc., affects.

The clinic also uses research methods based on the use of ultrasound - ultrasound cardiography.

Ultrasonic vibrations at a frequency of 500 kHz and above penetrate deeply through the tissues being generated by ultrasound emitters applied to the surface of the chest. Ultrasound is reflected from tissues of various densities - from the outer and inner surfaces of the heart, from blood vessels, from valves. The time it takes for the reflected ultrasound to reach the trapping device is determined.

If the reflecting surface moves, the return time of the ultrasonic vibrations changes. This method can be used to register changes in the configuration of the structures of the heart during its activity in the form of curves recorded from the screen of a cathode-ray tube. These techniques are called non-invasive.

Invasive techniques include:

Cardiac catheterization... An elastic catheter probe is inserted into the central end of the opened brachial vein and pushed towards the heart (into its right half). A probe is inserted into the aorta or left ventricle through the brachial artery.

Ultrasound scan- an ultrasound source is introduced into the heart using a catheter.

Angiography is a study of heart movements in the field of X-rays, etc.

Mechanical and sound manifestations of cardiac activity. Heart sounds, their genesis. Polycardiography. Comparison in time of periods and phases of the cardiac cycle of ECG and PCG and mechanical manifestations of cardiac activity.

Heart impulse. With diastole, the heart takes the shape of an ellipsoid. With systole, it takes on the shape of a ball, its longitudinal diameter decreases, and its transverse diameter increases. During systole, the apex rises and presses against the anterior chest wall. In the 5th intercostal space, a cardiac impulse occurs, which can be recorded ( apical cardiography). The expulsion of blood from the ventricles and its movement through the vessels, due to reactive recoil, causes vibrations of the whole body. Registration of these fluctuations is called ballistocardiography... The work of the heart is also accompanied by sound phenomena.

Heart sounds. When listening to the heart, two tones are determined: the first is systolic, the second is diastolic.

Systolic the tone is low, lingering (0.12 s). Several layering components are involved in its genesis:

1. Component of mitral valve closure.

2. Closing the tricuspid valve.

3. Pulmonary blood expulsion tone.

4. Aortic blood expulsion tone.

The characteristic of the I tone is determined by the tension of the leaflet valves, the tension of the tendon filaments, papillary muscles, and the walls of the ventricular myocardium.

The components of the expulsion of blood arise when the walls of the great vessels are stressed. I tone is well heard in the 5th left intercostal space. In case of pathology in the genesis of the I tone, the following are involved:

1. Component of aortic valve opening.

2. Opening the pulmonary valve.

3. Pulmonary artery stretching tone.

4. Tone distension of the aorta.

Amplification of the I tone can be at:

1. Hyperdynamics: physical activity, emotions.

In case of violation of the temporal relationship between atrial and ventricular systole.

With poor filling of the left ventricle (especially with mitral stenosis, when the valves do not fully open). The third variant of amplification of the I tone has significant diagnostic value.

Weakening of the I tone is possible with insufficiency of the mitral valve, when the valves are not tightly closed, with myocardial damage, etc.

II tone - diastolic(high, short 0.08 s). Occurs when the voltage of the closed semilunar valves. On a sphygmogram, its equivalent is incisure... The higher the pressure in the aorta and pulmonary artery, the higher the tone. It is well heard in the 2-intercostal space to the right and left of the sternum. It increases with sclerosis of the ascending aorta, pulmonary artery. The sound of I and II heart sounds most closely conveys the combination of sounds when pronouncing the phrase "LAB-DAB".

Symptoms

Cardiac

Cerebral

From other bodies

Causes of decreased ejection fraction

Diagnostics

Treatment

Forecast

Possible complications

Factors affecting the value of the cardiac output

Reference values ​​and standard assessment parameters

Cardiac Output Syndromes

What is heart ejection fraction

Reference values

Reasons for the decline

Symptoms

How to increase the ejection fraction of the heart

Normal fraction ejection

Ultrasound - norms and decoding

How to heal a low faction level?

Preventive methods

Concepts and symptoms

Normal fraction ejection

Ultrasound - norms and decoding

How to heal a low faction level?

Preventive methods

Norms in ultrasound for heart chambers

Norms in ultrasound for heart valves

Norms in ultrasound for the pericardium

PV rate

Causes of EF decrease

Symptoms of the disease

Treatment

Prophylaxis

Reference values and standard assessment parameters