The main terminology used to describe heart failure (HF) is historically based on the measurement of the left ventricular ejection fraction (LVEF). HF affects a wide range of patients, from those with normal LVEF (typically considered as ≥50 %; HF with preserved EF [HFpEF]) to those with reduced LVEF (typically considered as <40 %; HF with reduced EF [HFrEF]). Patients with an LVEF in the range of 40–49 % represent a ‘grey area’, which is now defined as HF with mid-range EF (HFmrEF).
It is remarkable that the new classification includes natriuretic peptides as key factors for the definition of HFmrEF and HFpEF. Fig. 1 proposes an algorithm to aid in decision making for the treatment of HF: Consensus recommendation: - Sacubitril/valsartan is recommended as a replacement for ACE-I/ARBs to reduce the risk of HF hospitalization and death in ambulatory patients with HFrEF who remain…
