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Related Concept Videos

Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

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Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
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Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
133
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

179
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
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Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

122
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
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Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

118
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
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Related Experiment Video

Updated: Nov 2, 2025

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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Heart Failure With Mid-range Ejection Fraction: A Distinctive Subtype or a Transitional Stage?

Qing Zhou1,2,3,4, Peixin Li1,2,3, Hengli Zhao1,2,3

  • 1State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Frontiers in Cardiovascular Medicine
|June 11, 2021
PubMed
Summary

Heart failure with mid-range ejection fraction (HFmrEF) is a complex condition, not a distinct disease, characterized by diverse patient profiles and associated conditions. Its classification remains debated, potentially representing a transitional stage between other heart failure types.

Keywords:
angiotensin receptor-neprilysin inhibitorsheart failuremid-range ejection fractionpreserved ejection fractionsodium-glucose co-transporter 2 inhibitors

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Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Heart failure with mid-range ejection fraction (HFmrEF) emerged as a distinct category in 2016.
  • Increasing research highlights HFmrEF's growing clinical significance.

Purpose of the Study:

  • To review the clinical characteristics, treatment, and prognosis of HFmrEF.
  • To explore the complex pathophysiology and heterogeneity of HFmrEF.
  • To differentiate HFmrEF from heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF).

Main Methods:

  • Literature review of studies on HFmrEF.
  • Analysis of diagnostic criteria and evolving understanding of HFmrEF.
  • Comparative analysis of HFmrEF, HFrEF, and HFpEF.

Main Results:

  • HFmrEF diagnostic criteria based on left ventricular ejection fraction (LVEF) are simple but LVEF is dynamic.
  • HFmrEF patients exhibit diverse characteristics and are often comorbid with other diseases.
  • The heterogeneity of HFmrEF may explain inconsistent clinical study outcomes.

Conclusions:

  • HFmrEF may represent a collection of patients with varied profiles rather than an independent disease entity.
  • The pathophysiological mechanisms and clinical phenotypes of HFmrEF are complex and diverse.
  • Further research is needed to clarify whether HFmrEF is a distinct subtype or a transitional stage of heart failure.