End-systolic volume

Last revised by Dr Joachim Feger on 27 Oct 2021

The end-systolic volume (ESV) is referred to as the volume of blood in the left or right ventricle at the end of the systolic ejection phase immediately before the beginning of diastole or ventricular filling. The end-systolic volume index (ESVI) is the end-systolic volume corrected for the body surface area (BSA).

In addition to the end-diastolic volume, the end-systolic volume is an essential parameter used for the assessment of cardiac function and the calculation of the respective stroke volumes and ejection fraction.

Widely- used postprocessing software solutions for cardiac MRI employ a combination of semi-automated feature recognition and manual contour correction based on Simpson’s method (“summation of disks”) 1.

The end-systolic volume is determined by the sum of the computed left/right ventricular cross-sectional areas determined by the endocardial contours at the end of the systolic ejection phase chosen as the images with the smallest blood volume accounting for slice thickness and gap 2.

End-systolic volume index is calculated as: ESVI = ESV/BSA [mL/m2

Papillary muscles are often included in blood volumes or mass but not in both 1. The ventricular outflow tract should also be included 2.

Normal values differ for the left and right ventricle depending on gender and age and with the imaging modality used 1-3. Values above the normal might indicate systolic dysfunction.

Normal values are derived from the publication by Kawel-Boehm with papillary muscles included in ventricular volumes 1:

Women (16-83 years):

  • ESV [mL]:           15-64 mL
  • ESVI [mL/m2]:   10-38 mL/m2

Men (16-83 years):

  • ESV [mL]:           19-88 mL
  • ESVI [mL/m2]:   11-47 mL/m2      

Women (20-83 years):

  • ESV [mL]:           20-80 mL
  • ESVI [mL/m2]:   13-48 mL/m2

Men (20-83 years):

  • ESV [mL]:           29-117 mL
  • ESVI [mL/m2]:   17-59 mL/m2      

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