LAUSR

Heart failure (HF) is a multifaceted syndrome accounting for a high rate of death and morbidity worldwide. The approach to this disease has traditionally been based on the evaluation of left ventricular ejection fraction (LVEF), with patients having HF with either reduced (HFrEF, LVEF< 40%), preserved (HFpEF, LVEF> 50%) or mid-range (HFmrEF, LVEF 40–50%) ejection fractions, each of these groups being considered distinct syndromes. Initially, the focus was on patients with HFrEF as these patients were easily identified and known to be at high risk of poor outcomes. However, as our populations age, the profile of patients with HF is evolving and the proportion of patients with HF having better LVEFs (i.e. those with HFpEF and HFmrEF) is increasing.1 Data from the Swedish Heart Failure Registry would suggest that, of patients with HF, 56% have HFrEF, 21% have HFmrEF, and that 23% have HFpEF.2 The characteristics of patients have been found to vary according to LVEF, with age and the proportion of women increasing with increasing LVEF. However, the similarities among patients, regardless of LVEF, are greater than the differences, and we now know that all patients with HF are at high risk of morbidity and mortality regardless of LVEF2,3.