Ejection Fraction

Hello :)

I was reading my Holter, stress test and echocardiography results today, and though I know some cardiology topics, I don't know so much about ejection fraction, other than >50% is normal.

Anyway, for my test results:
ECG at rest (one of many..)
NSR
Vent.rate 70 BPM
QT/QTc 370/403 ms
PR: 160 ms
QRS 112 ms
R axis: 59 deg.

Holter:
Min: 38. Avg: 76 Max: 184. Normal sinus rhythm.
Rare single PACs, otherwise normal findings. Tachycardia during exercise and bradycardia during sleep.

Stress EKG:
BP at rest 120/75. BP at 225w work load 210/90 @ HR 200. No sign of ischemia or arrhythmia. 1 PAC during cool-down, recognized by patient. Expected work load 250w, somewhat poor exercise condition, otherwise normal.

Echocardiography:
No dilation or hypertrophy. Normal LA, RA, LV and RV dimensions and wall thickness, normal valve function. Normal ejection fraction 57%. Aorta abdominalis normal with 17mm diameter.

Dx: I49.1 Premature atrial depolarization and F45.3 cardiac neurosis.

From what I understand and have read, those results are excellent. However, I think my EF is a bit low.

Is this caused by a somewhat poor exercise condition? Can it increase with exercise?
Anyway, when I see my results written, I can't really understand why I'm afraid of cardiac diseases :)

[itdood]

Your lvef is completely average, it's fine.  I don't think lvef is necessarily the best measure of an athletic heart.

If you want to understand it better, wikipedia has some good info on how it's calculated.  Running through the formula might give you a better idea on what the number means.  I've often found that crunching the numbers can paint a picture and a picture is worth a 1,000 words.

Stroke Volume and/or Cardiac Output would provide a better measure of an athletic heart, but those aren't typically done on workup tests.

Case in point, my LVEF is 72%.  I have average exercise tolerance.    I also know my heart is on the small side so my stroke volume is probably not that great compared to an athlete.

So, I think if you conditioned yourself your LVEF would probably stay the same.  This is because all the factors in the equation should in theory increase at the same rate therefore the measurement will stay the same.  However the stroke volume and cardiac output measure would increase.

[itdood]

Your lvef is completely average, it's fine.  I don't think lvef is necessarily the best measure of an athletic heart.

If you want to understand it better, wikipedia has some good info on how it's calculated.  Running through the formula might give you a better idea on what the number means.  I've often found that crunching the numbers can paint a picture and a picture is worth a 1,000 words.

Stroke Volume and/or Cardiac Output would provide a better measure of an athletic heart, but those aren't typically done on workup tests.

Case in point, my LVEF is 72%.  I have average exercise tolerance.    I also know my heart is on the small side so my stroke volume is probably not that great compared to an athlete.

So, I think if you conditioned yourself your LVEF would probably stay the same.  This is because all the factors in the equation should in theory increase at the same rate therefore the measurement will stay the same.  However the stroke volume and cardiac output measure would increase.

[is_something_wrong]

Thanks for a very good reply!

I forgot to say, my LV EDV is 125 ml. I suppose this is "normal". This will increase when I exercise?

From this,  my stroke volume is 125 x 0,57 = 71 ml and CO at heart rate 80 = 5,7 l/hour?
If my heart rate increases to 200, my CO is 14,2l/hour. Anyway, I guess my EF increases a bit during heavy exercise (mid to upper range heart rate), and reduces if HR is too high, like the torque on an engine, right?

A strange thing was, during my echocardiography, I was very scared and I felt this light, but somewhat elevated heart rate (100-120), possibly lowering EF? When I exercise, I can feel sort of heavy beats at high speed. When I'm anxious they're just fast, and light.

Is it possible that my EF during anxiety is lower if my heart rate is "light"?

Anyway, thanks for a great reply. I learn something every day :)

[itdood]

"Is it possible that my EF during anxiety is lower if my heart rate is "light"? "

I guess it could have.  The term that describes contractive force of the ventricular muscle is  "inotropy" (contractility).    I know beta blockers affect inotropy.  Make sense that anxiety would have an affect, what that affect is I don't know.