ABC Heart Fail Cardiomyop 2022; 2(1): 76-79

Rethinking the Definition of Heart Failure Based on Ejection Fraction: Reflections with Impact on Therapy

Marcelo Iorio Garcia

DOI: 10.36660/abchf.20220016

The universal definition of heart failure (HF) has been in a state of constant change in the last decades. It is necessary for the definition to be simple, comprehensible, and easily applied in clinically, as well as capable of differentiating patients’ stages and severity, allowing stratification of levels of care, especially regarding candidates for specific therapies.

In relation to ejection fraction (EF), which is the subject of our reflection, the most recent document proposed the following subdivisions according to left ventricular ejection fraction (LVEF): HF with reduced ejection fraction (HFrEF), EF ≤ 40%; HF with midrange ejection fraction (HFmrEF), EF 41% to 49%; HF with preserved ejection fraction (HFpEF), EF ≥ 50%; and HF with improved EF (HFiEF), HF with EF ≤ 40% that has increased by at least 10 points, with the second measurement reaching > 40%.

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