Heart Failure Seminar: Focus on HFmrEF Scientific Statement - OnDemand-Focus on HFmrEF Scientific Statement

Video Transcription

Video Summary

This webinar reviewed a recent scientific statement on heart failure with mildly reduced ejection fraction (HFmrEF). Jane Wilcox introduced the topic, outlining the agenda: epidemiology, pathophysiology, treatment strategies, and panel discussion.<br /><br />The epidemiology section emphasized that HFmrEF accounts for about 10% to 25% of prevalent heart failure and about 10% of new cases worldwide. Prevalence varies by setting and EF cutoffs, and EF is a moving target over time. Many patients transition between HFmrEF, HFrEF, and HFpEF, making longitudinal follow-up important. Clinically, HFmrEF often resembles HFrEF more than HFpEF, with more ischemic heart disease, atrial fibrillation, and diabetes.<br /><br />Barry Borlaug explained the physiology of ejection fraction as a marker of ventricular-arterial coupling and remodeling, not just contractility. He highlighted that HFmrEF lies between HFrEF and HFpEF, but is closer to HFrEF in biology and treatment response.<br /><br />Zach Cox reviewed treatment evidence. SGLT2 inhibitors had the strongest evidence and highest guideline recommendation. Beta blockers, RAAS inhibitors, and MRAs also have supportive data, though from subgroup analyses. He also discussed phenotype-specific therapies such as CRT for patients with high RV pacing, the role of CAD evaluation, and possible use of GLP-1 receptor agonists in obesity.<br /><br />The panel emphasized individualized care, considering phenotype, sex, ischemia, and trajectory rather than EF alone.

Keywords

heart failure with mildly reduced ejection fraction

HFmrEF

epidemiology

pathophysiology

SGLT2 inhibitors

beta blockers

RAAS inhibitors

mineralocorticoid receptor antagonists

individualized care