Heart Failure with Mid-Range Ejection Fraction – a New Category of Heart Failure or Still a Gray Zone

摘要

Heart failure with midrange ejection fraction (HFmrEF) is a new category of heart failure (HF), inbetween HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF).Previous studies were mainly conducted in HFrEF patients having a left ventricle ejection fraction (LVEF) lower than 35-40%. Later on, HFpEF captured the spot-light of the research field, and studies focused on patients with HF symptoms, but with a LVEF exceeding 50%.Consequently, a gap of knowledge comprising the LVEF between 40 and 49% has arisen. Current studies focusing on patients with HFmrEF are arguing the same conclusions or even having contradictory findings.HFmrEF has a prevalence of 10-20% of HF patients. HFmrEF has distinct, but intermediate clinical, structural and functional characteristics, as well as intermediate outcomes in comparison with HFrEF and HFpEF. However, there is still a large gap in evidence regarding detailed hemodynamic characteristics, long-term follow-up and optimal therapeutic options for these patients.Extensive research was recommended in order to improve knowledge about this “gray area” of patients with HF. Therefore, we aimed to provide an over-view of the existing and lacking data regarding patients with HFmrEF.