3
HFr EF
• The definition of HFrEF has been variable, but to date efficacious
therapies have been demonstrated only in patients with an EF of ≤35% or
≤40%.
• Approximately half of patients with HFrEF may also have variable degrees
of LV enlargement.
• Although coronary artery disease (CAD) with antecedent myocardial
infarction (MI) is a major cause of HFrEF, many other risk factors may
lead to LV enlargement and HFrEF.
HFp EF
• In patients with clinical HF, studies estimate that the prevalence of
HFpEF ranges from 40% to 71% because the EF cutoff has varied
between >40% and ≥55%.
• Proposed criteria to define HFpEF include:
▶ Clinical signs or symptoms of HF
▶ Evidence of preserved or normal left ventricular ejection fraction (LVEF)
and
▶ Evidence of abnormal LV diastolic dysfunction that can be determined by
Doppler echocardiography or cardiac catheterization.
• Prevalent associated conditions include:
▶ Hypertension (60%–89%)
▶ Older age, female
▶ Obesity
▶ CAD
▶ Diabetes mellitus
▶ Atrial fibrillation (AF)
▶ Hyperlipidemia
