Stroke volume, ejection fraction, and cardiac output

Definitions & Key takeaways

Stroke volume is the amount of blood the heart pumps with each beat. It is the difference between the end-diastolic volume and the end-systolic volume. The ejection fraction is the proportion of the end-diastolic volume that is pumped out with each beat. It is calculated as stroke volume divided by the end-diastolic volume. Cardiac output is the amount of blood the heart pumps in one minute and is equal to the heart rate multiplied by the stroke volume.

Chapters:

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Introduction0:00–0:15

The main job of the heart is to pump oxygenated blood with nutrients through the arteries to the body’s tissues and receive back deoxygenated blood full of waste products through the veins.

Stroke Volume0:15–1:16

Now, let’s zoom into the left ventricle. There’s a moment when the left ventricle is fully relaxed.
It occurs at the end of filling or diastole, also called the end-diastolic point, and the volume of blood within the left ventricle is called the end-diastolic volume, and it’s about 120 milliliters.
Then the left ventricle contracts, forcing blood through the aorta and into the whole arterial system. After that is another moment when the left ventricle is fully contracted.
It occurs at the end of contraction or systole, also called the end-systolic point, and the volume of blood within the left ventricle is called end-systolic volume, and it’s about 50 milliliters.
So, end-diastolic volume minus end-systolic volume, gives us the stroke volume, which is the volume of blood that the left ventricle ejects with every heartbeat, or stroke.
In this case, the stroke volume is 120 minus 50, which equals 70 milliliters. Stroke volume is a useful measurement, but it can vary based on the size of a person.

Ejection Fraction1:16–2:06

For example, a stroke volume of 50 milliliters might be absolutely fine for a small person with a small heart volume, but may be low for a large person with a bigger heart volume.
So another helpful measurement is the ejection fraction, which is the stroke volume divided by the end-diastolic volume, Ejection fraction = Stroke Volume / End- Diastolic Volume.
In a normal individual that’s 70/120, or about 58%, but it can fluctuate between 50 and 65% and still be considered normal.
In other words, at least half of the blood volume in the left ventricle should get pumped out during each heartbeat. In hearts that have a low contractility - a low force of contraction - the ejection fraction can fall below 50%.

Cardiac Output2:06–3:01

Every minute, though, our heart beats many times, so if we multiply the stroke volume times the heart rate, or the times our heart beats per minute, we’ll get the cardiac output, which is the total volume of blood the left ventricle ejects in one minute.
Using the stroke volume of 70 ml/ beat and a resting heart rate of 70 beats/minute, cardiac output is 4900 ml/min, or 4.9 liters/min.
Remember that a normal adult body contains approximately 5 liters of blood, so this means that every last drop of blood travels through the left ventricle at least once every minute!
Of course, the heart can adjust it’s heart rate and the stroke volume based on whether you’re sleeping or doing exercise.
In fact, trained athletes can have a cardiac output that reaches up to 35 liters/ minute! The cardiac output flows through the arteries and is distributed to the various organs meet their oxygen and nutrient demands.

Tissue Perfusion3:01–3:42

Of all of the organs, the liver receives the largest amount of blood flow. The kidneys also get a lot of blood flow, but less than the liver.
However, when correcting for the mass of these tissues, the kidney gets much more blood per gram of tissue than any other organ - and this is called tissue perfusion.
So flow refers to the total amount of blood volume going someplace like an organ over time, and perfusion refers to the total amount of blood volume going to a gram of tissue over time.
All right, as a quick recap, stroke volume is the volume of blood pumped by the left ventricle in a single heartbeat. The ejection fraction is the percentage of blood that is pumped out of the left ventricle with each heartbeat, which serves as a measure of the heart’s contractility.

Review3:42–4:03

Finally, cardiac output is the volume of blood pumped in one minute.