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6th May 2025
Left ventricular ejection fraction
The most recent guidance introduces a standardised classification of heart failure by the left ventricle ejection fraction. The universal definition of heart failure is a clinical syndrome with current or prior signs and symptoms caused by a structural and/or functional abnormality determined by an ejection fraction of <50% and corroborated with either an elevated natriuretic peptide level or objective evidence of cardiogenic pulmonary or systemic congestion.
| Left ventricular ejection fraction | Classification |
|---|---|
| ≤40% | Heart failure with reduced ejection fraction (HFrEF) |
| 41-49% | Heart failure with mildly reduced ejection fraction (HFmrEF) |
| ≥50% | Heart failure with preserved ejection fraction (HFpEF) |
| Baseline ≤40%, a ≥10 point increase from baseline LVEF and a second measurement of LVEF >40% | Heart failure with improved ejection fraction (HFimpEF) |
Table 5: Classification of heart failure by left ventricular ejection fraction
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