On this page
Deep Dive — Evidence Details
Overview
Heart failure is a heterogeneous clinical syndrome rather than a single disease entity. Because the diagnostic criteria, pathophysiology, and evidence-based (GDMT) differ fundamentally between reduced, mildly reduced, and preserved ejection fraction, as well as between acute and chronic states, the topic requires decomposition into distinct clinical entities to ensure therapeutic accuracy.
Forms / Subtopics
- ▸HFrEF (Heart Failure with reduced Ejection Fraction): Heart failure with LVEF ≤40%; focus on quadruple therapy (ARNI/ACEi, BB, MRA, SGLT2i) and device-based interventions.
- ▸HFpEF (Heart Failure with preserved Ejection Fraction): Heart failure with LVEF ≥50%; focus on diagnostic scoring (H2FPEF), SGLT2 inhibitors, and management of metabolic comorbidities.
- ▸Acute Decompensated Heart Failure: Rapid onset or worsening of HF symptoms; focus on hemodynamic phenotypes (wet/dry, warm/cold), IV diuretics, and inotropes.
- ▸HFmrEF (Heart Failure with mildly reduced Ejection Fraction): Heart failure with LVEF 41-49%; an intermediate phenotype with management strategies often extrapolated from HFrEF evidence.
- ▸Right-sided Heart Failure: Isolated or secondary failure of the right ventricle; focus on pulmonary hypertension, RV infarction, and volume management.
- ▸Advanced Heart Failure: Stage D heart failure; focus on mechanical circulatory support (LVAD), cardiac transplantation, and palliative care.
HFrEF (Heart Failure with reduced Ejection Fraction) — Heart failure with LVEF ≤40%; focus on quadruple therapy (ARNI/ACEi, BB, MRA, SGLT2i) and device-based interventions.
— Heart failure with LVEF ≥50%; focus on diagnostic scoring (H2FPEF), SGLT2 inhibitors, and management of metabolic comorbidities.
— Rapid onset or worsening of HF symptoms; focus on hemodynamic phenotypes (wet/dry, warm/cold), IV diuretics, and inotropes.
— Heart failure with LVEF 41-49%; an intermediate phenotype with management strategies often extrapolated from HFrEF evidence.
— Isolated or secondary failure of the right ventricle; focus on pulmonary hypertension, RV infarction, and volume management.
— Stage D heart failure; focus on mechanical circulatory support (LVAD), cardiac transplantation, and palliative care.