title: Heart failure: what does ejection fraction have to do with it?
abstract: Heart failure (HF) occurs across the entire range of left ventricular (LV) ejection fractions (EF), not just reduced EF. Nearly half or more patients presenting with HF have a preserved EF>0.50 (HFpEF). Diastolic dysfunction is apparent in all patients with HF, regardless of EF. A preserved EF indicates that the end-diastolic volume is appropriate for the stroke volume, and a reduced EF indicates that the end-diastolic volume is enlarged relative to stroke volume (i.e. the LV is dilated). Most therapies proven to be effective in HF with a reduced EF (ACE-inhibitors, angiotensin receptor blockers, beta-blockers, and cardiac resynchronization) reverse LV dilation. These therapies have not been proven to be effective in HFpEF. Increasing c-GMP may be a treatment target in HFpEF, and potential ways of increasing c-GMP are being studied. Finally, comorbidities are important in HFpEF and are additional targets for therapy.
authors.affiliation: Section on Cardiology, Wake Forest School of Medicine, Winston-Salem, NC 27157-1045, USA.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Iwano
authors.forename: William C
authors.initials: WC
authors.lastname: Little
mesh_terms: D006333:Heart Failure / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D013318:Stroke Volume / Q000502:physiology*
keywords: Ejection fraction; Heart failure; Heart failure with preserved ejection fraction