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Table 1. Definitions of HFrEF and HFpEF
Classification EF Description
I. Heart failure
with reduced
ejection fraction
(HFrEF)
≤40%
Also referred to as "systolic HF." Randomized clinical
trials have mainly enrolled patients with HFrEF, and it
is only in these patients that efficacious therapies have
been demonstrated to date.
II. Heart failure
with preserved
ejection fraction
(HFpEF)
≥50% Also referred to as "diastolic HF." Several different
criteria have been used to further define HFpEF. e
diagnosis of HFpEF is challenging because it is largely
one of excluding other potential noncardiac causes
of symptoms suggestive of HF. To date, efficacious
therapies have not been identified.
IIa. HFpEF,
borderline
41%–
49%
ese patients fall into a borderline or intermediate
group. eir characteristics, treatment patterns, and
outcomes appear similar to those of patients with
HFpEF.
IIb. HFpEF,
improved
>40% It has been recognized that a subset of patients with
HFpEF previously had HFrEF. ese patients with
improvement or recovery in EF may be clinically
distinct from those with persistently preserved or
reduced EF. Further research is needed to better
characterize these patients.
Key Points
