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The 2021 European Society of Cardiology guidelines for the diagnosis and treatment of acute and chronic heart failure subdivided heart failure into three categories on the basis of LVEF: [21] normal or preserved LVEF [≥50%] (HFpEF) moderately reduced LVEF [in the range of 41–49%] (HFmrEF) reduced LVEF [≤40%] (HFrEF)]
Heart failure with preserved ejection fraction (HFpEF) is a form of heart failure in which the ejection fraction – the percentage of the volume of blood ejected from the left ventricle with each heartbeat divided by the volume of blood when the left ventricle is maximally filled – is normal, defined as greater than 50%; [1] this may be measured by echocardiography or cardiac catheterization.
In normal subjects, the left ventricular ejection fraction (LVEF) should be about 50% [9] (range, 50-80%). There should be no area of abnormal wall motion (hypokinesis, akinesis or dyskinesis). Abnormalities in cardiac function may be manifested as a decrease in LVEF and/or the presence of abnormalities in global and regional wall motion.
This is defined as a left ventricular ejection fraction (LVEF) of 40% or less. About half of heart failure patients have a reduced ejection fraction. [2] Other types of heart failure are heart failure with mildly reduced ejection fraction (LVEF between 40% and 50%) and heart failure with preserved ejection fraction (LVEF 50% or higher). [1] [3]
Using a special pacing algorithm, biventricular cardiac resynchronization therapy (CRT) can initiate a normal sequence of ventricular depolarization. In people with LVEF below 35% and prolonged QRS duration on ECG (LBBB or QRS of 150 ms or more), an improvement in symptoms and mortality occurs when CRT is added to standard medical therapy. [122]
Reference ranges (reference intervals) for blood tests are sets of values used by a health professional to interpret a set of medical test results from blood samples. Reference ranges for blood tests are studied within the field of clinical chemistry (also known as "clinical biochemistry", "chemical pathology" or "pure blood chemistry"), the ...
A transthoracic echocardiogram (TTE) is the most common type of echocardiogram, which is a still or moving image of the internal parts of the heart using ultrasound.In this case, the probe (or ultrasonic transducer) is placed on the chest or abdomen of the subject to get various views of the heart.
The high-risk patient populations in these studies were defined as those with severe ischemic cardiomyopathy (determined by a reduced left ventricular ejection fraction (LVEF)). The LVEF criteria used in these trials ranged from less than or equal to 30% in MADIT-II to less than or equal to 40% in MUSTT. [75] [77]
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