Monday, 11 July 2016

Ready for another heart failure subgroup? How about HFrecEF?

In the language of heart failure, we're familiar with the terms HFrEF (heart failure with a reduced ejection fraction), and HFpEF (heart failure with a preserved ejection fraction). More recently, we had a proposed new category of HFmrEF (heart failure with a mid-range ejection fraction, namely an LVEF of 40-49%). In fact we've already talked about HFmrEF in a recent blog post.

We now have another subgroup to consider - HFrecEF. This is heart failure with a recovered ejection fraction, and refers to those patients who have had a reduced ejection fraction in the past, but whose left ventricular ejection fraction (LVEF) has subsequently improved.

HFrecEF, a new subgroup in heart failure

More specifically, HFrecEF is defined when the patient's current LVEF is >40%, but has previously been documented to be ≤40%.

Why is the concept of HFrecEF gaining attention? It's because of a recent paper by Kalogeropoulos and colleagues, published in JAMA Cardiology. This paper looked at patients with HFrecEF in a retrospective cohort study, and found that the clinical course of patients with HFrecEF was different to those with HFrEF and HFpEF, with fewer clinical events such as deaths or hospitalizations during the study period.

Why does this matter? Well, if patients with HFrecEF are a distinct subgroup with different (better) clinical outcomes compared to those with HFrEF and HFpEF, then this may have an impact on the findings of heart failure trials more generally. The authors therefore propose that patients with HFrecEF may need to be considered as a separate group in future heart failure studies.

If you'd like to read the original paper, you can do so here:


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