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Heart Failure With Mid-Range (Borderline) Ejection Fraction: Clinical Implications and Future Directions.
Jeffrey J Hsu1, Boback Ziaeian2, Gregg C Fonarow3
1Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, California.
JACC. Heart Failure
|October 17, 2017
Summary
Heart failure with mid-range ejection fraction (HFmrEF) is less studied than other heart failure types. Further research is needed to characterize HFmrEF and find effective treatments beyond managing comorbidities.
Area of Science:
- Cardiology
- Heart Failure Research
Background:
- Heart failure with mid-range ejection fraction (HFmrEF) is defined by a left ventricular ejection fraction (LVEF) of 40-49%.
- This LVEF range is less studied than HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF).
- HFmrEF patients share clinical and prognostic similarities with HFpEF but have distinctions.
Purpose of the Study:
- To review the clinical epidemiology, pathophysiology, and prognosis of HFmrEF.
- To compare HFmrEF characteristics with HFpEF and HFrEF.
- To identify potential targeted therapies for HFmrEF.
Main Methods:
- Literature review of studies on HFmrEF.
- Comparative analysis of HFmrEF with HFpEF and HFrEF.
- Summary of current treatment strategies and emerging therapeutic signals.
Main Results:
- HFmrEF patients exhibit a clinical profile and prognosis closer to HFpEF.
- Current treatments emphasize aggressive comorbidity management.
- Some studies suggest potential benefits from therapies used in HFrEF, like neurohormonal blockade.
Conclusions:
- HFmrEF represents a distinct group requiring further characterization.
- Targeted therapies, potentially including neurohormonal blockade, warrant investigation for HFmrEF.
- Effective management strategies are needed to reduce cardiovascular morbidity and mortality in HFmrEF.