Xanthopoulos A, Giamouzis G, Skoularigis J, Triposkiadis F. Heart failure with reduced, mildly reduced, or preserved left ventricular ejection fraction: Has reasoning been lost? World J Cardiol 2022; 14(7): 438-445 [PMID: 36161058 DOI: 10.4330/wjc.v14.i7.438]
Corresponding Author of This Article
Andrew Xanthopoulos, FACC, MD, PhD, Doctor, Department of Cardiology, University Hospital of Larissa, Mezourlo, Larissa 41110, Greece. andrewvxanth@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Jul 26, 2022; 14(7): 438-445 Published online Jul 26, 2022. doi: 10.4330/wjc.v14.i7.438
Heart failure with reduced, mildly reduced, or preserved left ventricular ejection fraction: Has reasoning been lost?
Andrew Xanthopoulos, Grigorios Giamouzis, John Skoularigis, Filippos Triposkiadis
Andrew Xanthopoulos, Grigorios Giamouzis, John Skoularigis, Filippos Triposkiadis, Department of Cardiology, University Hospital of Larissa, Larissa 41110, Greece
Author contributions: Xanthopoulos A and Triposkiadis F conceived the study; Xanthopoulos A, Giamouzis G, Skoularigis J, and Triposkiadis F wrote the manuscript; Skoularigis J and Giamouzis G revised the manuscript critically for important intellectual content; All authors provided comments on the manuscript and gave final approval of the version to be published.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Andrew Xanthopoulos, FACC, MD, PhD, Doctor, Department of Cardiology, University Hospital of Larissa, Mezourlo, Larissa 41110, Greece. andrewvxanth@gmail.com
Received: March 11, 2022 Peer-review started: March 11, 2022 First decision: May 31, 2022 Revised: June 9, 2022 Accepted: July 8, 2022 Article in press: July 8, 2022 Published online: July 26, 2022 Processing time: 130 Days and 19.5 Hours
Abstract
Left ventricular (LV) ejection fraction (LVEF), defined as LV stroke volume divided by end-diastolic volume, has been systematically used for the diagnosis, classification, and management of heart failure (HF) over the last three decades. HF is classified as HF with reduced LVEF, HF with midrange or mildly reduced LVEF, and HF with preserved LVEF using arbitrary, continuously changing LVEF cutoffs. A prerequisite for using this LVEF-based terminology is knowledge of the LVEF normal range, which is lacking and may lead to erroneous conclusions in HF, especially at the higher end of the LVEF spectrum.
Core Tip: Left ventricular ejection fraction (LVEF) has been consistently used for the diagnosis, classification, and management of heart failure (HF) over the last three decades. HF is classified as HF with reduced LVEF, HF with midrange or mildly reduced LVEF, and HF with preserved LVEF using arbitrary, continuously changing LVEF cutoffs. A prerequisite for using this terminology is knowledge of the LVEF normal range, which is lacking and may lead to erroneous conclusions, especially at the higher end of the LVEF spectrum.
