Ejection Fraction Calculator — LVEF from LV Dimensions (Teichholz)
Estimate left ventricular ejection fraction (LVEF) from the end-diastolic and end-systolic LV internal diameters with the Teichholz formula — volumes, stroke volume, fractional shortening and the ASE category.
How it works
Teichholz volume V = 7 / (2.4 + D) × D³ (D in cm, V in mL). EDV from LVIDd, ESV from LVIDs; stroke volume = EDV − ESV; EF = (EDV − ESV) / EDV × 100. Fractional shortening = (LVIDd − LVIDs) / LVIDd × 100.
The Teichholz formula (Teichholz et al., American Journal of Cardiology 1976) turns a single linear LV diameter into a volume by assuming an ellipsoid ventricle. It is quick but unreliable when the ventricle is distorted or has regional wall-motion abnormalities, so the ASE/EACVI 2015 chamber quantification guideline recommends biplane Simpson (method of discs) or 3D volumes instead. Categories use the ASE normal range (men 52–72%, women 54–74%; 41–51/53% mildly, 30–40% moderately and under 30% severely abnormal) and the universal heart-failure EF ranges.
Worked example
A man with LVIDd 5.0 cm and LVIDs 3.4 cm: EDV = 7/7.4 × 125 = 118 mL and ESV = 7/5.8 × 39.3 = 47 mL, so stroke volume is 71 mL and EF = 70.8/118.2 = 59.9% — normal, in the preserved EF range. Fractional shortening is 32.0%.
Sources: Lang RM et al. — ASE/EACVI chamber quantification (JASE 2015) · Teichholz LE et al. — Am J Cardiol 1976
Frequently asked questions
What is a normal ejection fraction?
By the ASE/EACVI 2015 guideline a normal LVEF is 52–72% in men and 54–74% in women. 41–51% (men) or 41–53% (women) is mildly abnormal, 30–40% moderately and below 30% severely abnormal.
How accurate is the Teichholz method?
It is reasonable in a symmetric, normally shaped ventricle, but it extrapolates one diameter to the whole ventricle and so over- or under-estimates EF when there are regional wall-motion abnormalities, aneurysm or a spherical ventricle. Biplane Simpson or 3D echo is preferred.
What is the difference between EF and fractional shortening?
Fractional shortening is the percentage change in diameter (normal roughly 25–43%); EF is the percentage change in volume. Because volume scales with the cube of the diameter, EF is always larger than FS.
What are HFrEF, HFmrEF and HFpEF?
The universal definition of heart failure uses EF ≤ 40% for heart failure with reduced EF, 41–49% for mildly reduced EF and ≥ 50% for preserved EF. The diagnosis of heart failure itself needs symptoms and other evidence, not EF alone.
Related calculators
Clinical decision tool for education and for use by trained clinicians alongside clinical judgement — not a diagnosis and not a substitute for medical assessment. Formulas and cut-offs come from the cited sources; local protocols may differ.