What have we learned about heart failure with mid‐range ejection fraction one year after its introduction?

Nauta, Joske; Hummel, Yoran M.; Melle, Joost P. van; Meer, Peter van der; Lam, Carolyn S.P.; Ponikowski, Piotr; Voors, Adriaan A.

doi:10.1002/ejhf.1058

Cited by 71 publications

(87 citation statements)

References 27 publications

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“…[170][171][172][173][174][175][176] With Highlights in heart failure respect of outcomes, prognosis of the patients with HFmrEF is slightly better than that of the patients with HFrEF in most, but not all, 177 of the studies. a LVEF between 40% and 49% (HFmrEF).…”

Section: Heart Failure With Mid-range Ejection Fractionmentioning

confidence: 99%

Highlights in heart failure

et al. 2019

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Heart failure (HF) remains a major cause of mortality, morbidity, and poor quality of life. It is an area of active research. This article is aimed to give an update on recent advances in all aspects of this syndrome. Major changes occurred in drug treatment of HF with reduced ejection fraction (HFrEF). Sacubitril/valsartan is indicated as a substitute to ACEi/ARBs after PARADIGM-HF (hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.73 to 0.87 for sacubitril/valsartan vs. enalapril for the primary endpoint and Wei, Lin and Weissfeld HR 0.79, 95% CI 0.71-0.89 for recurrent events). Its initiation was then shown as safe and potentially useful in studies in patients hospitalized for acute HF. More recently, DAPA-HF trial showed the beneficial effects of the sodium-glucose transporter type 2 (SGLT2) inhibitor dapaglifozin vs. placebo, added to optimal standard therapy [HR, 0.74; 95% CI, 0.65 to 0.85;0.74; 95% CI, 0.65 to 0.85 for the primary endpoint]. Trials with other SGLT 2 inhibitors and in other patients, such as those with HF with preserved ejection fraction (HFpEF) or with recent decompensation, are ongoing. Multiple studies showed the unfavourable prognostic significance of abnormalities in serum potassium levels. Potassium lowering agents may allow initiation and titration of mineralocorticoid antagonists in a larger proportion of patients. Meta-analyses suggest better outcomes with ferric carboxymaltose in patients with iron deficiency. Drugs effective in HFrEF may be useful also in HF with mid-range ejection fraction. Better diagnosis and phenotype characterization seem warranted in HF with preserved ejection fraction. These and other burning aspects of HFpEF research are summarized and reviewed in this article.A multiparametric approach is often proposed for risk stratification of HF patients. The prognostic accuracy of the metabolic exercise test data combined with cardiac and kidney indexes risk score was found as superior to the HF Survival Score and Seattle HF model risk scores in a cohort of 6112 1106 D. Tomasoni et al.

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Section: Heart Failure With Mid-range Ejection Fractionmentioning

confidence: 99%

Highlights in heart failure

et al. 2019

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“…The clinical significance of HF with mid‐range ejection fraction (HFmrEF), first introduced in the 2016 ESC HF guidelines, has become clearer in the last year . Abdul‐Rahim et al .…”

Section: Clinical Trials Of Medical Therapymentioning

confidence: 99%

July 2018 at a glance: practical guidance in acute heart failure, pathophysiology and clinical trials of medical therapy

Metra

2018

European J of Heart Fail

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“…The 2016 European Society of Cardiology (ESC) guidelines on heart failure (HF) introduced the term of HF with mid‐range ejection fraction (HFmrEF) for those patients with a left ventricular ejection fraction (LVEF) of 40–49% . This new classification has fostered studies describing these patients' characteristics …”

Section: Left Ventricular Ejection Fraction: a Moving Targetmentioning

confidence: 99%

December 2017 at a glance: left ventricular ejection fraction, exercise capacity, peripartum cardiomyopathy

Metra

2017

European J of Heart Fail

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What have we learned about heart failure with mid‐range ejection fraction one year after its introduction?

Cited by 71 publications

References 27 publications

Highlights in heart failure

Highlights in heart failure

July 2018 at a glance: practical guidance in acute heart failure, pathophysiology and clinical trials of medical therapy

December 2017 at a glance: left ventricular ejection fraction, exercise capacity, peripartum cardiomyopathy

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