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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.
An ejection fraction (EF) is the volumetric fraction (or portion of the total) of fluid (usually blood) ejected from a chamber (usually the heart) with each contraction (or heartbeat). It can refer to the cardiac atrium , [ 1 ] cardiac ventricle , [ 2 ] gall bladder, [ 3 ] or leg veins, [ 4 ] although if unspecified it usually refers to the ...
Left-sided heart failure may be present with a reduced ejection fraction or with a preserved ejection fraction. [10] Heart failure is not the same as cardiac arrest, in which blood flow stops completely due to the failure of the heart to pump. [12] [13] Diagnosis is based on symptoms, physical findings, and echocardiography. [6]
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]
Armstrong PW, Butler J et al. "Effect of Vericiguat vs Placebo on Quality of Life in Patients with Heart Failure and Preserved Ejection Fraction: The VITALITY-HFpEF Randomized Clinical Trial." JAMA 2020. Butler J et al. "Redefining Heart Failure with a Reduced Ejection Fraction." JAMA 2019.
Heart failure, particularly with reduced ejection fraction (HFrEF), is a major cause of morbidity and mortality worldwide. Aldosterone, a hormone that promotes sodium retention and potassium excretion, plays a significant role in the pathophysiology of heart failure by contributing to fluid overload, myocardial fibrosis, and vascular damage.
The preferred term is now heart failure with normal ejection fraction (HFNEF) or heart failure with preserved ejection fraction (HFPEF). This is common and is often seen in hypertensive heart disease, hypertrophic cardiomyopathy and aortic stenosis, and may comprise as much as 50% of the total heart failure population. [22]
Heart failure, both with and without preserved ejection fraction, though through different mechanisms, result in an increase in left ventricular end-diastolic pressure (LVEDP). [7] Because CPP is measured by the difference in aortic and LVEDP pressures, an increase in LVEDP will decrease CPP.
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