Biplane Simpson EF

Biplane Simpson EF: LV ejection fraction from apical 2- and 4-chamber disk summation method.

Apical 2-Chamber View

LV End-Diastolic Volume (mL)

LV End-Systolic Volume (mL)

Apical 4-Chamber View

LV End-Diastolic Volume (mL)

LV End-Systolic Volume (mL)

Formula

EF = (avg EDV − avg ESV) / avg EDV × 100%

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Primary LV systolic function assessment on transthoracic echo

HF diagnosis and severity stratification

Post-MI LV function assessment

Cardiotoxicity monitoring (chemotherapy, HER2 inhibitors)

Serial monitoring in LVAD candidates

More accurate than M-mode (Teichholz) in most patients

Key Advantages

Less dependent on geometric assumptions vs. M-mode

Validated against cardiac MRI gold standard

Incorporates regional function variations

Recommended by ESC/AHA guidelines as primary measurement

Reproducible across operators with good image quality

How it Works

Calculation Methodology

Requires apical 2-chamber and 4-chamber views

Tracings of LV endocardium in diastole and systole

LV volume = Σ cylinder volumes stacked base-to-apex

Formula: EF = (EDV − ESV) / EDV × 100%

Biplane method averages 2- and 4-chamber calculations

LV EF Classification

LVEF (%)	Classification	Clinical Correlate
>50	Normal	No LV dysfunction
41–49	Mildly Reduced	HFmrEF (newer category)
31–40	Moderately Reduced	HFrEF (may be symptomatic)
≤30	Severely Reduced	HFrEF; high risk; LVAD/transplant candidate

Last Comprehensive Review: 2026-07-17

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Primary LV systolic function assessment on transthoracic echo

HF diagnosis and severity stratification

Post-MI LV function assessment

Cardiotoxicity monitoring (chemotherapy, HER2 inhibitors)

Serial monitoring in LVAD candidates

More accurate than M-mode (Teichholz) in most patients

Key Advantages

Less dependent on geometric assumptions vs. M-mode

Validated against cardiac MRI gold standard

Incorporates regional function variations

Recommended by ESC/AHA guidelines as primary measurement

Reproducible across operators with good image quality

How it Works

Calculation Methodology

Requires apical 2-chamber and 4-chamber views

Tracings of LV endocardium in diastole and systole

LV volume = Σ cylinder volumes stacked base-to-apex

Formula: EF = (EDV − ESV) / EDV × 100%

Biplane method averages 2- and 4-chamber calculations

LV EF Classification

LVEF (%)	Classification	Clinical Correlate
>50	Normal	No LV dysfunction
41–49	Mildly Reduced	HFmrEF (newer category)
31–40	Moderately Reduced	HFrEF (may be symptomatic)
≤30	Severely Reduced	HFrEF; high risk; LVAD/transplant candidate

Last Comprehensive Review: 2026-07-17

Recent Journal Updates

WHO NewsJul 20, 2026

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Clinical Context

We think this has broad domain relevance to Biplane Simpson EF.

WHO NewsJul 15, 2026

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Clinical Context

We think this has broad domain relevance to Biplane Simpson EF.

WHO NewsJul 15, 2026

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Clinical Context

We think this has broad domain relevance to Biplane Simpson EF.

Biplane Simpson EF

When to Use

When to Use

Key Advantages

How it Works

Calculation Methodology

LV EF Classification

Clinical Pearls

Technical Considerations

Clinical Pitfalls

Next Steps

LVEF >50% (Normal)

LVEF 41–49% (Mildly Reduced / HFmrEF)

LVEF 31–40% (Moderately Reduced)

LVEF ≤30% (Severely Reduced)

Complementary Calculators

The Evidence

Validation

Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.

Origins & History

Development

When to Use

When to Use

Key Advantages

How it Works

Calculation Methodology

LV EF Classification

Clinical Pearls

Technical Considerations

Clinical Pitfalls

Next Steps

LVEF >50% (Normal)

LVEF 41–49% (Mildly Reduced / HFmrEF)

LVEF 31–40% (Moderately Reduced)

LVEF ≤30% (Severely Reduced)

Complementary Calculators

The Evidence

Validation

Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.

Origins & History

Development

Recent Journal Updates

Biplane Simpson EF

When to Use

When to Use

Key Advantages

How it Works

Calculation Methodology

LV EF Classification

Clinical Pearls

Technical Considerations

Clinical Pitfalls

Next Steps

LVEF >50% (Normal)

LVEF 41–49% (Mildly Reduced / HFmrEF)

LVEF 31–40% (Moderately Reduced)

LVEF ≤30% (Severely Reduced)

Complementary Calculators

The Evidence

Validation

Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.

Origins & History

Development

When to Use

When to Use

Key Advantages

How it Works

Calculation Methodology

LV EF Classification

Clinical Pearls

Technical Considerations

Clinical Pitfalls

Next Steps

LVEF >50% (Normal)

LVEF 41–49% (Mildly Reduced / HFmrEF)

LVEF 31–40% (Moderately Reduced)

LVEF ≤30% (Severely Reduced)

Complementary Calculators

The Evidence

Validation