Heart failure experts agree: HFmrEF should not be ignored
Heart failure with mildly reduced ejection fraction (HFmrEF), defined as an ejection fraction of 41-49%, affects up to one in four of all heart failure patients around the world. Data on the treatment and management of HFmrEF are limited, but a new scientific statement from the Heart Failure Society of America (HFSA) highlights the importance of taking this condition seriously and providing patients with the care they need.
The scientific statement, published in full in the Journal of Cardiac Failure, was developed to examine the “epidemiology, clinical characteristics and pathophysiology” of HFmrEF while providing care teams with helpful treatment recommendations.[1]
“HFmrEF has often been treated as a gray zone, but patients in this group face real risks, including hospitalization and disease progression,” co-lead author Jane E. Wilcox, MD, MSc, a heart failure specialist with the Bluhm Cardiovascular Institute of Northwestern University, said in a statement. “This statement reinforces that HFmrEF warrants the same level of clinical attention and longitudinal management as other heart failure phenotypes.”
Wilcox et al. wrote that HFmrEF closely resembles heart failure with reduced ejection fraction (HFrEF) with its increased risks of ischemic heart disease, atrial fibrillation and diabetes. In addition, a significant number of patients with HFmrEF transition to HFrEF over time. It’s for these reasons that the guideline-directed medical therapy (GDMT) for HFrEF are believed to be an appropriate treatment option for patients with HFmrEF.
The authors also noted that ejection fraction is not the only measure cardiologists and other physicians should consider when evaluating a patient’s myocardial function. Chamber remodeling, afterload, ischemic burden and various comorbidities must also be considered.
“By clarifying how to approach HFmrEF, this statement helps close a longstanding gap in heart failure care and highlights important areas for future research,” co-lead author Barry A. Borlaug, MD, a heart failure cardiologist with Mayo Clinic, said in the same statement.
Click here for the full HFSA scientific statement. A list of 10 key takeaways from the authors is available here.
Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.