cardiology

LVEF by Simpson Biplane Method

Simpson's biplane method of discs for measuring left ventricular ejection fraction (LVEF) on echocardiography. Gold standard 2D echo technique using apical 4-chamber and 2-chamber views.

Score interpretation

Normal LVEF

→ LVEF ≥55%: Normal left ventricular systolic function. If symptomatic — consider HFpEF (LVEF ≥50%), diastolic assessment, E/e' ratio, left atrial volume index. Treat underlying cause.

Mildly Reduced LVEF (HFmrEF)

→ LVEF 41–54%: Mildly reduced EF (HFmrEF). Consider RAAS inhibitor, beta-blocker, SGLT2 inhibitor. Repeat echo in 3–6 months; cardiology review; investigate aetiology (ischaemia, viability imaging).

Moderately Reduced LVEF (HFrEF)

→ LVEF 30–40%: Moderately reduced EF (HFrEF). Initiate GDMT: ACEi/ARB/ARNI + beta-blocker + MRA + SGLT2i. Consider ICD if LVEF <35% on optimal therapy ≥3 months (NYHA II–III). Cardiology review.

Severely Reduced LVEF

→ LVEF <30%: Severely reduced EF. Maximum GDMT (ARNI preferred over ACEi); CRT-D if LBBB + QRS ≥150 ms + NYHA II-III; ICD; LVAD evaluation; transplant listing assessment; palliate if non-viable.

Interpretation bands for the Simpson's LVEF. Apply clinical judgement and local guidance.

References

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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