Preserved left Ventricular Systolic Function?



I have written many messages on here an always get great help back, and I just have a question please that is quite worrying me.

I had contacted my cardiology team about a few symptoms I have been facing recently ( extreme fatigue, headaches  and no energy ect.) and I had a phone call and a letter sent back. 

In my letter the notes say Jun 2022, normal LV function and size with no aortic root dilation. 

But then further down in the letter it says " his most recent echocardiogram in July 2020 showed preserved left ventricular systolic function". I am slightly confused as my last echo was 2 years after that, and also Preserved left ventricular systolic function is something I have never been told about, is it a bad thing??

Thank you all so much,


Hayden x


it's good

by Tracey_E - 2023-03-22 12:43:24

It means it has stayed the same. So, good news. 

I would seek further advice but all looks normal from June 2022 report

by Gemita - 2023-03-22 15:05:08

Jayden, I am reassured that your latest report from June 2022, states normal LV function and size with no aortic root dilation.  However I would ask your doctors the significance of your 2020 echocardiogram report in particular about the “preserved ejection fraction”.  This is something that I normally hear with signs of heart failure.  For example, my husband has heart failure with “preserved ejection fraction”.  I would ask because you were clearly unaware of such a diagnosis.  Perhaps your latest blood test deficiencies (folate and Vit D) contributed to your fatigue and other symptoms at the time of your diagnosis?

Based on the most recent report, your Left Ventricular function is normal Hayden but for peace of mind do ask a few more questions

Thank you all

by PacerPrice - 2023-03-22 15:08:39

Thank you,

if i have preserved LV systolic function, but normal LV size and function, can that mean it's not heart failure? i'm not sure what's wrong and it's worrying me 

call but

by Tracey_E - 2023-03-22 15:10:09

When in doubt, call and ask exactly what it means. But "preserved" means stays the same. 

You need to ask your doctors Hayden to explain what this means for you

by Gemita - 2023-03-22 15:34:50

Heart failure with preserved ejection fraction (HFpEF) is a type of heart failure that occurs when the muscle in the left ventricle stiffens and is less able to relax, so the pressure inside the heart rises. HFpEF is usually caused by coronary artery disease, valvular heart disease, diabetes, obesity, or hypertension.

There are though many conditions that may reduce our ejection fraction into heart failure territory, anaemia being one of them.  You could well be suffering from anaemia from your vitamin/mineral deficiencies, which is why I suggested you speak to your team again. 

Just to put this all into perspective, my sister's ejection fraction dropped right down to 16%.  Her ejection fraction is now 45%.  She is almost out of heart failure territory with lifestyle changes, treatment of her anaemia and pneumonia.  

I would respectfully ask your team to explain whether you were found to have had heart failure in the past, since you were clearly not aware of such a diagnosis?  I would want to know what your Ejection Fraction is at the moment, so perhaps another echocardiogram would give piece of mind?


by Penguin - 2023-03-22 15:49:05

If you can get an appointment (or phonecall) with your GP it might be helpful to write a list of questions out and then ask the GP to explain each of them. Hearing from us (with varying opinions) or via a letter sometimes raises more questions - particularly if the letter uses language you're not familiar with. 

Check if you'd like some reassurance, but I too think that 'preserved LV systolic function' is a good thing. I understand it to mean 'unaffected' and functioning just fine, but am aware that this may confuse you further, so please ring your GP for clarification.  


confused and anxious

by PacerPrice - 2023-03-22 16:01:31

Thank you all. 

I have never been told I have heart failure, or anything wrong with my ejection fraction, heart function or structure. the most recent check shows normal heart function and structure. 

should this be okay, can I stop worrying? I will call the hospital tomorrow but I am just sat worrying now, surely i'd know if that was the issue? 

My tiredness is really worrying me, but I know I have the folate and vitamin D deficiency. Surely over the months if it was heart related more symptoms would've presented , like swelling and shortness of breath when laying down? 


Thank you,


no need to worry

by Tracey_E - 2023-03-22 16:10:13

From what you have said, there is no need to worry about heart failure. That's why they do regular echos on us, to watch for any early signs of decrease in function. 

thank you

by PacerPrice - 2023-03-22 16:22:35

Thank you Tracey, 


Do you think if my tiredness was genuinely heart failure, after 4 months i'd have some worse symptoms by now. I'm just so scared living my life constantly worrying somethings going to deteriorate or go wrong 

hard to say

by Tracey_E - 2023-03-22 16:53:13

That's a question for your doctors. Many many things can cause tiredness, including vitamin D deficiency. It's easy to automatically blame everything on our hearts, but odds are it's something else, something with an easy fix. 

If you had signs of early heart failure, they would be treating it with medication to keep it from getting worse. Some people have symptoms, others do not. If the echo starts to show decreased function, then they'll look further to see what's going on and the best course of treatment. But your function is preserved, which means stayed the same, which means you are in good shape.

My ep is an adult congential specialist so he sees people like you and me all day long. He said that heart failure for us is rare, well under 10%. If we go 5 years paced without a decrease in function, he almost never sees it happen later. So for both of us, the odds of pacer induced heart failure are very small. If we do end up being the exception, it's not a death sentence. It's very treatable, esp when caught early. Which is why they do regular echos. They want to see function remaining the same. Which yours is. 

Living in fear of something constantly going wrong is not a healthy mindset. Worry and stress will cause more damage than pacemakers. There are counselors, books, podcasts out there that can help with mindset, help learn not to jump to conclusions and expect the worst. 

There is no evidence whatsoever that pacing will shorten our lifespan. I think we actually have an advantage because we are more aware and therefore more likely to take care of ourselves, and we are well monitored so if something is going on we are more likely to catch it early. I absolutely get where you are coming from, because I've been there. But I'm quite a few years older than you so more time to adapt. I've had a lot of years feeling really good with the pacemaker and living an active life. I've lost friends who were perfectly healthy, until they weren't. Cancer, car accidents, sudden onset diabetes... life happens. And through it all, my pacer keeps on pacing, my heart function remains the same.

All we can do is take the best care of ourselves that we can- eat right, exercise, stay diligent about follow up care. And let the rest go, worrying over things not in our control will take years off your life. I know it's easier said than done, but there are resources out there to help with mindset. It makes me sad to see you worry so much. You have every reason to expect to live a healthy life.


by Penguin - 2023-03-22 16:54:21

It's awful to feel like that Haydn.   It can take over your life when you worry constantly. It may be helpful to raise the constant worry with your GP if its getting on top of you. 


Yes please don't worry

by Gemita - 2023-03-22 16:54:32

Hayden yes, please don’t worry.  I didn’t intend to cause fear.  I am sure your doctors would have mentioned such a diagnosis and perhaps given you more meds to take than the one beta blocker you are currently taking.  Clearly in your previous post too your cardiologist referred you back to the GP which seems to suggest that they were not concerned about your symptoms and felt your GP was more than capable of taking care of them.

Remember too that echo results may differ depending on the level of expertise of the technician carrying it out.  My sister’s initial echo result of 16% function now looks to have been erroneous, since her recovery has been quite remarkable with medication alone.

Worry will not help Hayden.  Fill your mind with nice, positive thoughts.  That will help more than worry.  Tomorrow please speak to your doctor for reassurance and let us know how you are?


by Lavender - 2023-03-22 18:16:08

You're fine. Your cardiologist would have told you if anything was wrong. They wouldn't have referred you back to your GP if it was something heart related. 

Extreme fatigue

by Rch - 2023-03-22 19:35:07

Hayden, At such a young age, you shouldn't be feeling extreme fatigue, headache or lethargy unless caused by a medication or a transient viral infection. Folate or Vit D deficiency is very unlikely to cause these symptoms. Subclinical folate or Vit D defieciency is not too uncommon even in the developed countries. I advise you to consult your PCP on your symptoms. He/She might run some tests to get to the bottom of it!  I wish you good luck. 

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