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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
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Heart Failure With Midrange Ejection Fraction-What Is It, If Anything?
Jacinthe Boulet1, Emmanuelle Massie1, Jean-Lucien Rouleau1
1Division of Cardiology, Department of Medicine, Montréal Heart Institute, Montréal, Québec, Canada.
The Canadian Journal of Cardiology
|December 4, 2020
Summary
Heart failure with midrange ejection fraction (HFmrEF) patients are a diverse group. Left ventricular ejection fraction (LVEF) is a continuum, not a definitive classification for heart failure.
Area of Science:
- Cardiology
- Clinical Medicine
- Heart Failure Research
Background:
- Heart failure with midrange ejection fraction (HFmrEF), defined by left ventricular ejection fractions (LVEFs) of 41%-49%, constitutes a significant patient subset.
- Despite established guidelines, the clinical significance of HFmrEF remains debated due to patient heterogeneity.
- HFmrEF patients share characteristics with both heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF).
Purpose of the Study:
- To review the pathophysiologic mechanisms contributing to HFmrEF.
- To delineate the clinical and imaging differences and similarities between HFpEF, HFrEF, and HFmrEF.
- To emphasize the continuum of heart failure and the limitations of LVEF-based classification.
Main Methods:
- Clinical review of existing literature.
- Analysis of pathophysiologic mechanisms, biomarker profiles, comorbidities, and clinical characteristics.
- Comparison of clinical and imaging features across HF phenotypes.
Main Results:
- HFmrEF patients exhibit heterogeneity, overlapping with HFpEF and HFrEF.
- Left ventricular ejection fraction (LVEF) represents a continuum in heart failure, not discrete categories.
- Pathophysiology, etiology, and comorbidities are crucial for understanding and managing HF.
Conclusions:
- Left ventricular ejection fraction (LVEF) is an important but oversimplified measure in heart failure.
- Heart failure is best understood as a continuum, necessitating a personalized approach.
- Focusing on underlying pathophysiology, etiology, and comorbidities is essential for tailored patient care.
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