Heart failure with mid-range ejection fraction: pro and cons of the new classification of Heart Failure by European Society of Cardiology guidelines.


Journal Article (Review)

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.

Full Text

Duke Authors

Cited Authors

  • Branca, L; Sbolli, M; Metra, M; Fudim, M

Published Date

  • April 2020

Published In

Volume / Issue

  • 7 / 2

Start / End Page

  • 381 - 399

PubMed ID

  • 32239646

Pubmed Central ID

  • 32239646

Electronic International Standard Serial Number (EISSN)

  • 2055-5822

Digital Object Identifier (DOI)

  • 10.1002/ehf2.12586


  • eng

Conference Location

  • England