Heart Failure With Mid-Range Ejection Fraction - The 'Middle' Child of the Heart Failure Siblings

摘要

Heart failure (HF) affects over 6 million adults in the United States. Although not without its criticism, HF has been classified based on left ventricular ejection fraction (LVEF) into 2 major phenotypes: HF with reduced ejection fraction (HFrEF) with EF <40% and HF with preserved ejection fraction (HFpEF) with EF >50%. This classification leaves a grey zone of 40%-49%. Results from the Acute Decompensated HF Registry (ADHERE) and Organized Program to Initiate Lifesav-ing Treatment in Hospitalized Patients with HF (OPTIMIZE-HF) studies suggest that individuals with mildly reduced EF demonstrate distinct baseline characteristics and outcomes different from HFrEF and HFpEF patients.1-2 This grey zone was first officially described in American College of Cardiology/American Heart Association 2013 guidelines as HF with borderline EF3 and later christened HF with mid-range EF (HFmrEF) in the European Society of Cardiology 2016 guideline.