Hospital Universitário Antônio Pedro, Niterói, RJ - Brazil.
Arq Bras Cardiol. 2019 Jul 15;112(6):784-790. doi: 10.5935/abc.20190079.
In 2016, the European Society of Cardiology (ESC) recognized heart failure (HF) with ejection fraction between 40 and 49% as a new HF phenotype, HF with mid-range ejection fraction (HFmrEF), with the main purpose of encouraging studies on this new category. In 2018, the Brazilian Society of Cardiology adhered to this classification and introduced HFmrEF in Brazil. This paper presents a narrative review of what the literature has described about HFmrEF. The prevalence of patients with HFmrEF ranged from 13 to 24% of patients with HF. Analyzing the clinical characteristics, HFmrEF shows intermediate characteristics or is either similar to HF with preserved ejection fraction (HFpEF) or to HF with reduced fraction (HFrEF). Regarding the prognosis, HFmrEF's all-cause mortality is similar to HFpEF's and lower than HFrEF's. Studies that analyzed cardiac mortality concluded that there was no significant difference between HFmrEF and HFrEF, both of which were lower than HFpEF. Despite the significant increase of publications on HFmrEF, there is a great scarcity of prospective studies and clinical trials that allow delineating specific therapies for this new phenotype. To better treat HFmrEF patients, it is fundamental that cardiologists and internists understand the differences and similarities of this new phenotype.
2016 年，欧洲心脏病学会（ESC）将射血分数在 40%至 49%之间的心力衰竭（HF）认定为一种新的心力衰竭表型，即射血分数中间范围的心衰（HFmrEF），主要目的是鼓励对这一新类别的研究。2018 年，巴西心脏病学会遵循这一分级，并在巴西引入了 HFmrEF。本文对文献中描述的 HFmrEF 进行了叙述性综述。HFmrEF 患者的患病率在 HF 患者中占 13%至 24%。分析临床特征，HFmrEF 表现出中间特征，或类似于射血分数保留的心衰（HFpEF）或射血分数降低的心衰（HFrEF）。在预后方面，HFmrEF 的全因死亡率与 HFpEF 相似，低于 HFrEF。分析心脏死亡率的研究得出结论，HFmrEF 与 HFrEF 之间没有显著差异，两者均低于 HFpEF。尽管 HFmrEF 的出版物显著增加，但缺乏前瞻性研究和临床试验，无法为这一新表型确定具体的治疗方法。为了更好地治疗 HFmrEF 患者，心脏病专家和内科医生了解这种新表型的差异和相似之处至关重要。
