What is Heart Failure with Mid-range Ejection Fraction? A New Subgroup of Patients with Heart Failure

Nadar, Sunil; Tariq, Osama

doi:10.15420/cfr.2018:7:2

Cited by 14 publications

(12 citation statements)

References 29 publications

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“…Similarly, even from a prognostic viewpoint, patients with HFmrEF have been reported to show an "intermediate" behavior between HFrEF and HFpEF patients (21,26,31). Eventually, differently from the "older sibling child", it has been shown that HFmrEF patients are usually undertreated with the HF disease modifier drugs, namely angiotensin converting enzyme inhibitors Adding further complexity to the HFmrEF clinical scenario, it is still debated whether the HFmrEF should be considered as a real clinical entity or just as a transition step of the dynamic functional and structural evolution of the continuous HF spectrum (24,33,34). However, another viewpoint, actually the prevalent one, distinguishes those HFmrEF patients who recovered from a depressed systolic function (rec-HFmrEF) from those who never experienced a EF lower than 40% (de novo HFmrEF).…”

Section: Resultsmentioning

confidence: 99%

Cardiovascular Death Risk in Recovered Mid-Range Ejection Fraction Heart Failure: Insights From Cardiopulmonary Exercise Test

Magrì¹,

Piepoli²,

Corrà³

et al. 2020

Journal of Cardiac Failure

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Section: Resultsmentioning

confidence: 99%

Cardiovascular Death Risk in Recovered Mid-Range Ejection Fraction Heart Failure: Insights From Cardiopulmonary Exercise Test

Magrì¹,

Piepoli²,

Corrà³

et al. 2020

Journal of Cardiac Failure

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“…Relative inefficiency of components of GDMT in HFpEF and HFmrEF phenotypes might have reduced the statistical power of GDMT-HFrEF relationship relative to the whole group. It should also be kept in mind that the study did not consider de novo GDMT, rather made a snapshot prevalence of GDMT; hence, incident GDMT might have yielded positive outcomes (43)(44)(45)(46)(47)(48)(49)(50). Furthermore, the duration of GDMT might not be sufficient to yield prognostic benefit in 1 year, even in incident GDMT cases, and might have already yielded positive outcomes in prevalent GDMT cases (particularly those enrolled as patients with CHF were those who survived via already initiated GDMT).…”

Section: Discussionmentioning

confidence: 99%

Snapshot Evaluation of Acute and Chronic Heart Failure in Real Life in Turkey: Follow up data for mortality

et al. 2019

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Snapshot evaluation of acute and chronic heart failure in real-life in Turkey: A follow-up data for mortality Objective: Heart failure (HF) is a progressive clinical syndrome. SELFIE-TR is a registry illustrating the overall HF patient profile of Turkey. Herein, all-cause mortality (ACM) data during follow-up were provided. Methods: This is a prospective outcome analysis of SELFIE-TR. Patients were classified as acute HF (AHF) versus chronic HF (CHF) and HF with reduced ejection fraction (HFrEF), HF with mid-range ejection fraction, and HF with preserved ejection fraction and were followed up for ACM. Results: There were 1054 patients with a mean age of 63.3±13.3 years and with a median follow-up period of 16 (7-17) months. Survival data within 1 year were available in 1022 patients. Crude ACM was 19.9% for 1 year in the whole group. ACM within 1 year was 13.7% versus 32.6% in patients with CHF and AHF, respectively (p<0.001). Angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, beta blocker, and mineralocorticoid receptor antagonist were present in 70.6%, 88.2%, and 50.7%, respectively. In the whole cohort, survival curves were graded according to guideline-directed medical therapy (GDMT) scores ≤1 versus 2 versus 3 as 28% versus 20.2% versus 12.2%, respectively (p<0.001). Multivariate analysis of the whole cohort yielded age (p=0.009) and AHF (p=0.028) as independent predictors of mortality in 1 year. Conclusion: One-year mortality is high in Turkish patients with HF compared with contemporary cohorts with AHF and CHF. Of note, GDMT score is influential on 1-year mortality being the most striking one on chronic HFrEF. On the other hand, in the whole cohort, age and AHF were the only independent predictors of death in 1 year.

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“…In contrast to HFpEF and HFrEF, there is a relative paucity in literature discussing the phenotype of HFmrEF, and as such, this condition has often been referred to as the “middle child” in the HF family. The pathophysiology of HFmrEF, which accounts for ~10–20% of all HF patients (Nadar and Tariq, 2018), is largely unknown. Current evidence indicates that HFmrEF may be the outcome of a progressive worsening in LV function in HFpEF patients, most notably observed in those with concomitant coronary artery disease, which is associated with a deterioration in LVEF (Lam and Solomon, 2014).…”

Section: Mechanisms Of Hfmrefmentioning

confidence: 99%

Novel Mechanisms in Heart Failure With Preserved, Midrange, and Reduced Ejection Fraction

et al. 2019

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What is Heart Failure with Mid-range Ejection Fraction? A New Subgroup of Patients with Heart Failure

Cited by 14 publications

References 29 publications

Cardiovascular Death Risk in Recovered Mid-Range Ejection Fraction Heart Failure: Insights From Cardiopulmonary Exercise Test

Cardiovascular Death Risk in Recovered Mid-Range Ejection Fraction Heart Failure: Insights From Cardiopulmonary Exercise Test

Snapshot Evaluation of Acute and Chronic Heart Failure in Real Life in Turkey: Follow up data for mortality

Novel Mechanisms in Heart Failure With Preserved, Midrange, and Reduced Ejection Fraction

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