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Heart failure with mildly reduced ejection fraction: emerging frontiers in clinical characteristics, prognosis, and

Zhi Shang1, Xinyu Wang1, Wei Gao1

  • 1Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, 100191 Beijing, China.

Reviews in Cardiovascular Medicine
|January 29, 2022
PubMed

Insights

Heart failure with mildly reduced ejection fraction (HFmrEF) is now a distinct clinical classification. Emerging research suggests HFmrEF patients may benefit from therapies similar to those with lower ejection fractions.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Heart Failure Research

Background:

  • Heart failure (HF) is a major cause of morbidity and mortality.
  • Previous guidelines classified HF based on ejection fraction, with a gap for mid-range values.
  • The 2016 ESC guideline introduced 'heart failure with mid-range ejection fraction' (HFmREF).

Purpose of the Study:

  • To review the clinical characteristics, prognosis, and treatment of HFmrEF.
  • To highlight the evolution of HFmrEF classification and understanding.
  • To provide guidance for clinicians managing HFmrEF patients.

Main Methods:

  • Review of recent clinical studies and guidelines.
  • Analysis of emerging diagnostic technologies (e.g., speckle tracking echocardiography, cardiac MRI).
  • Evaluation of novel biomarkers for HF assessment.

Main Results:

  • The term 'HF with mid-range ejection fraction' was updated to 'heart failure with mildly reduced ejection fraction' (HFmrEF).
  • Growing evidence supports HFmrEF as a distinct entity.
  • Novel technologies and biomarkers enhance HF evaluation.

Conclusions:

  • HFmrEF represents a significant patient population.
  • Patients with HFmrEF may respond to existing HF therapies.
  • Continued research and updated guidelines are crucial for optimal HFmrEF management.

Keywords:
BiomarkersExtracellular volume fractionGlobal longitudinal strainHeart failure with mildly reduced ejection fractionPrognosisT1 mappingTreatment

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