Open AccessHeart failure with mid‐range ejection fraction: pro and cons of the new classification of Heart Failure by European Society of Cardiology guidelines
Author(s) -
Branca Luca,
Sbolli Marco,
Metra Marco,
Fudim Marat
Publication year - 2020
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.12586
Subject(s) - ejection fraction , medicine , heart failure , cardiology , observational study , intensive care medicine , etiology
Currently, the assessment of left ventricular ejection fraction (LVEF) is the cornerstone of the classification of patients with heart failure (HF). The mid‐range LVEF (HFmrEF) category was identified in an attempt to uncover specific characteristics of these patients. So far, the analysis of trials, registries, and observational studies have demonstrated that patients with mid‐range LVEF belong to a patient cohort with generally intermediate clinical profile as compared with other groups but with a remarkable variety of intrinsic phenotypes. This is due to the limitations of LVEF as the sole criterion to categorize patients with HF and characterize their prognosis, above all when it is >40%. To better define the HFmrEF phenotype, it is reasonable to consider other parameters, such as LVEF changes over time, HF aetiology, co‐morbidities, and other imaging parameters. A multiparametric evaluation may contextualize a patient with HFmrEF in a more defined phenotype with a specific prognosis.