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guideline was released, several clinical registry trials have reported the clinical characteristics and mortality rates in patients with HFmrEF. According to those trials, patients with HFmrEF are more likely to show ischemic, diabetic, and hypertensive characteristics than patients with other types of HF.5–9 Additionally, responses to HF therapy and prognosis are intermediate between patients with HFrEF and those with HFpEF. However, little is known about the association between changes in EF and prognosis in patients with HFmrEF. In this issue of the Journal, Gwag et al10 report on selected follow-up data on LVEF from the Korean Acute Heart Failure (KoAHF) registry11 and they investigate the S ince we started our cardiology residency, we have been measuring left ventricular ejection fraction (LVEF) to evaluate patients’ cardiac function. Although LVEF is not an ideal parameter to stratify patients with heart failure (HF), many clinical trials that have set LVEF as an entry criterion clearly showed its utility in determining the outcome of HF therapies. Therefore, we decided to use LVEF as a convenient and useful parameter to make decisions on the therapeutic strategy of HF. Previous studies of patients with HF and an EF ranging from 35% to 50% have mentioned that this range is a borderline or gray area.1–3 Recently, the 2016 European Society of Cardiology guidelines proposed a new HF phenotype, termed HF with mid-range LVEF (HFmrEF), for patients with HF and an LVEF of 40–49%.4 Since this Article p ????

Monitoring Changes in Ejection Fraction in Patients With Heart Failure and Mid-Range Ejection Fraction