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Mildly reduced left ventricular ejection fraction

MedGen UID:
868399
•Concept ID:
C4022793
•
Finding
Synonym: Mildly reduced ejection fraction
 
HPO: HP:0012663

Definition

A small reduction in the fraction of blood pumped from the left ventricle with each cardiac cycle. The normal range in adults is at least 50 percent, and a mild reduction is defined as 40-49 percent. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVMildly reduced left ventricular ejection fraction

Conditions with this feature

Progressive external ophthalmoplegia with mitochondrial DNA deletions, autosomal recessive 5
MedGen UID:
1648331
•Concept ID:
C4748184
•
Disease or Syndrome
See: Condition Record
Progressive external ophthalmoplegia with mitochondrial DNA deletions, autosomal recessive 5

Professional guidelines

PubMed

Expert Review on Contemporary Management of Common Benign Pleural Effusions.
Porcel JM
Semin Respir Crit Care Med 2023 Aug;44(4):477-490. Epub 2023 Jun 1 doi: 10.1055/s-0043-1769096. PMID: 37263288
From Genetic Mutations to Molecular Basis of Heart Failure Treatment: An Overview of the Mechanism and Implication of the Novel Modulators for Cardiac Myosin.
Chen YJ, Chien CS, Chiang CE, Chen CH, Cheng HM
Int J Mol Sci 2021 Jun 21;22(12) doi: 10.3390/ijms22126617. PMID: 34205587Free PMC Article

Recent clinical studies

Etiology

SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials.
Vaduganathan M, Docherty KF, Claggett BL, Jhund PS, de Boer RA, Hernandez AF, Inzucchi SE, Kosiborod MN, Lam CSP, Martinez F, Shah SJ, Desai AS, McMurray JJV, Solomon SD
Lancet 2022 Sep 3;400(10354):757-767. Epub 2022 Aug 27 doi: 10.1016/S0140-6736(22)01429-5. PMID: 36041474
Efficacy and Safety of Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction According to Age: The DELIVER Trial.
Peikert A, Martinez FA, Vaduganathan M, Claggett BL, Kulac IJ, Desai AS, Jhund PS, de Boer RA, DeMets D, Hernandez AF, Inzucchi SE, Kosiborod MN, Lam CSP, Shah SJ, Katova T, Merkely B, Vardeny O, Wilderäng U, Lindholm D, Petersson M, Langkilde AM, McMurray JJV, Solomon SD
Circ Heart Fail 2022 Oct;15(10):e010080. Epub 2022 Aug 27 doi: 10.1161/CIRCHEARTFAILURE.122.010080. PMID: 36029467
Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction.
Solomon SD, McMurray JJV, Claggett B, de Boer RA, DeMets D, Hernandez AF, Inzucchi SE, Kosiborod MN, Lam CSP, Martinez F, Shah SJ, Desai AS, Jhund PS, Belohlavek J, Chiang CE, Borleffs CJW, Comin-Colet J, Dobreanu D, Drozdz J, Fang JC, Alcocer-Gamba MA, Al Habeeb W, Han Y, Cabrera Honorio JW, Janssens SP, Katova T, Kitakaze M, Merkely B, O'Meara E, Saraiva JFK, Tereshchenko SN, Thierer J, Vaduganathan M, Vardeny O, Verma S, Pham VN, Wilderäng U, Zaozerska N, Bachus E, Lindholm D, Petersson M, Langkilde AM; DELIVER Trial Committees and Investigators
N Engl J Med 2022 Sep 22;387(12):1089-1098. Epub 2022 Aug 27 doi: 10.1056/NEJMoa2206286. PMID: 36027570
Heart failure with mid-range or mildly reduced ejection fraction.
Savarese G, Stolfo D, Sinagra G, Lund LH
Nat Rev Cardiol 2022 Feb;19(2):100-116. Epub 2021 Sep 6 doi: 10.1038/s41569-021-00605-5. PMID: 34489589Free PMC Article
Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure: Endorsed by the Canadian Heart Failure Society, Heart Failure Association of India, Cardiac Society of Australia and New Zealand, and Chinese Heart Failure Association.
Bozkurt B, Coats AJS, Tsutsui H, Abdelhamid CM, Adamopoulos S, Albert N, Anker SD, Atherton J, Böhm M, Butler J, Drazner MH, Michael Felker G, Filippatos G, Fiuzat M, Fonarow GC, Gomez-Mesa JE, Heidenreich P, Imamura T, Jankowska EA, Januzzi J, Khazanie P, Kinugawa K, Lam CSP, Matsue Y, Metra M, Ohtani T, Francesco Piepoli M, Ponikowski P, Rosano GMC, Sakata Y, Seferović P, Starling RC, Teerlink JR, Vardeny O, Yamamoto K, Yancy C, Zhang J, Zieroth S
Eur J Heart Fail 2021 Mar;23(3):352-380. Epub 2021 Mar 3 doi: 10.1002/ejhf.2115. PMID: 33605000

Diagnosis

Heart failure: an update from the last years and a look at the near future.
Riccardi M, Sammartino AM, Piepoli M, Adamo M, Pagnesi M, Rosano G, Metra M, von Haehling S, Tomasoni D
ESC Heart Fail 2022 Dec;9(6):3667-3693. doi: 10.1002/ehf2.14257. PMID: 36546712Free PMC Article
Efficacy and Safety of Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction According to Age: The DELIVER Trial.
Peikert A, Martinez FA, Vaduganathan M, Claggett BL, Kulac IJ, Desai AS, Jhund PS, de Boer RA, DeMets D, Hernandez AF, Inzucchi SE, Kosiborod MN, Lam CSP, Shah SJ, Katova T, Merkely B, Vardeny O, Wilderäng U, Lindholm D, Petersson M, Langkilde AM, McMurray JJV, Solomon SD
Circ Heart Fail 2022 Oct;15(10):e010080. Epub 2022 Aug 27 doi: 10.1161/CIRCHEARTFAILURE.122.010080. PMID: 36029467
Redefining the epidemiology of cardiac amyloidosis. A systematic review and meta-analysis of screening studies.
Aimo A, Merlo M, Porcari A, Georgiopoulos G, Pagura L, Vergaro G, Sinagra G, Emdin M, Rapezzi C
Eur J Heart Fail 2022 Dec;24(12):2342-2351. Epub 2022 May 16 doi: 10.1002/ejhf.2532. PMID: 35509173Free PMC Article
Renal effects of guideline-directed medical therapies in heart failure: a consensus document from the Heart Failure Association of the European Society of Cardiology.
Mullens W, Martens P, Testani JM, Tang WHW, Skouri H, Verbrugge FH, Fudim M, Iacoviello M, Franke J, Flammer AJ, Palazzuoli A, Barragan PM, Thum T, Marcos MC, Miró Ò, Rossignol P, Metra M, Lassus J, Orso F, Jankowska EA, Chioncel O, Milicic D, Hill L, Seferovic P, Rosano G, Coats A, Damman K
Eur J Heart Fail 2022 Apr;24(4):603-619. Epub 2022 Mar 27 doi: 10.1002/ejhf.2471. PMID: 35239201
Heart failure with mid-range or mildly reduced ejection fraction.
Savarese G, Stolfo D, Sinagra G, Lund LH
Nat Rev Cardiol 2022 Feb;19(2):100-116. Epub 2021 Sep 6 doi: 10.1038/s41569-021-00605-5. PMID: 34489589Free PMC Article

Therapy

Sacubitril/valsartan in heart failure with mildly reduced or preserved ejection fraction: a pre-specified participant-level pooled analysis of PARAGLIDE-HF and PARAGON-HF.
Vaduganathan M, Mentz RJ, Claggett BL, Miao ZM, Kulac IJ, Ward JH, Hernandez AF, Morrow DA, Starling RC, Velazquez EJ, Williamson KM, Desai AS, Zieroth S, Lefkowitz M, McMurray JJV, Braunwald E, Solomon SD
Eur Heart J 2023 Aug 14;44(31):2982-2993. doi: 10.1093/eurheartj/ehad344. PMID: 37210743Free PMC Article
SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials.
Vaduganathan M, Docherty KF, Claggett BL, Jhund PS, de Boer RA, Hernandez AF, Inzucchi SE, Kosiborod MN, Lam CSP, Martinez F, Shah SJ, Desai AS, McMurray JJV, Solomon SD
Lancet 2022 Sep 3;400(10354):757-767. Epub 2022 Aug 27 doi: 10.1016/S0140-6736(22)01429-5. PMID: 36041474
Efficacy and Safety of Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction According to Age: The DELIVER Trial.
Peikert A, Martinez FA, Vaduganathan M, Claggett BL, Kulac IJ, Desai AS, Jhund PS, de Boer RA, DeMets D, Hernandez AF, Inzucchi SE, Kosiborod MN, Lam CSP, Shah SJ, Katova T, Merkely B, Vardeny O, Wilderäng U, Lindholm D, Petersson M, Langkilde AM, McMurray JJV, Solomon SD
Circ Heart Fail 2022 Oct;15(10):e010080. Epub 2022 Aug 27 doi: 10.1161/CIRCHEARTFAILURE.122.010080. PMID: 36029467
Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction.
Solomon SD, McMurray JJV, Claggett B, de Boer RA, DeMets D, Hernandez AF, Inzucchi SE, Kosiborod MN, Lam CSP, Martinez F, Shah SJ, Desai AS, Jhund PS, Belohlavek J, Chiang CE, Borleffs CJW, Comin-Colet J, Dobreanu D, Drozdz J, Fang JC, Alcocer-Gamba MA, Al Habeeb W, Han Y, Cabrera Honorio JW, Janssens SP, Katova T, Kitakaze M, Merkely B, O'Meara E, Saraiva JFK, Tereshchenko SN, Thierer J, Vaduganathan M, Vardeny O, Verma S, Pham VN, Wilderäng U, Zaozerska N, Bachus E, Lindholm D, Petersson M, Langkilde AM; DELIVER Trial Committees and Investigators
N Engl J Med 2022 Sep 22;387(12):1089-1098. Epub 2022 Aug 27 doi: 10.1056/NEJMoa2206286. PMID: 36027570
Heart failure with mid-range or mildly reduced ejection fraction.
Savarese G, Stolfo D, Sinagra G, Lund LH
Nat Rev Cardiol 2022 Feb;19(2):100-116. Epub 2021 Sep 6 doi: 10.1038/s41569-021-00605-5. PMID: 34489589Free PMC Article

Prognosis

Sodium-glucose co-transporter 2 inhibitors in heart failure with mildly reduced or preserved ejection fraction: an updated systematic review and meta-analysis.
Wang Y, Gao T, Meng C, Li S, Bi L, Geng Y, Zhang P
Eur J Med Res 2022 Dec 29;27(1):314. doi: 10.1186/s40001-022-00945-z. PMID: 36581880Free PMC Article
Heart failure: an update from the last years and a look at the near future.
Riccardi M, Sammartino AM, Piepoli M, Adamo M, Pagnesi M, Rosano G, Metra M, von Haehling S, Tomasoni D
ESC Heart Fail 2022 Dec;9(6):3667-3693. doi: 10.1002/ehf2.14257. PMID: 36546712Free PMC Article
Recent advances in the pharmacological therapy of chronic heart failure: Evidence and guidelines.
Tsutsui H
Pharmacol Ther 2022 Oct;238:108185. Epub 2022 Apr 9 doi: 10.1016/j.pharmthera.2022.108185. PMID: 35413307
Heart failure with mid-range or mildly reduced ejection fraction.
Savarese G, Stolfo D, Sinagra G, Lund LH
Nat Rev Cardiol 2022 Feb;19(2):100-116. Epub 2021 Sep 6 doi: 10.1038/s41569-021-00605-5. PMID: 34489589Free PMC Article
Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure: Endorsed by the Canadian Heart Failure Society, Heart Failure Association of India, Cardiac Society of Australia and New Zealand, and Chinese Heart Failure Association.
Bozkurt B, Coats AJS, Tsutsui H, Abdelhamid CM, Adamopoulos S, Albert N, Anker SD, Atherton J, Böhm M, Butler J, Drazner MH, Michael Felker G, Filippatos G, Fiuzat M, Fonarow GC, Gomez-Mesa JE, Heidenreich P, Imamura T, Jankowska EA, Januzzi J, Khazanie P, Kinugawa K, Lam CSP, Matsue Y, Metra M, Ohtani T, Francesco Piepoli M, Ponikowski P, Rosano GMC, Sakata Y, Seferović P, Starling RC, Teerlink JR, Vardeny O, Yamamoto K, Yancy C, Zhang J, Zieroth S
Eur J Heart Fail 2021 Mar;23(3):352-380. Epub 2021 Mar 3 doi: 10.1002/ejhf.2115. PMID: 33605000

Clinical prediction guides

Sodium-glucose co-transporter 2 inhibitors in heart failure with mildly reduced or preserved ejection fraction: an updated systematic review and meta-analysis.
Wang Y, Gao T, Meng C, Li S, Bi L, Geng Y, Zhang P
Eur J Med Res 2022 Dec 29;27(1):314. doi: 10.1186/s40001-022-00945-z. PMID: 36581880Free PMC Article
Atrial Fibrillation and Dapagliflozin Efficacy in Patients With Preserved or Mildly Reduced Ejection Fraction.
Butt JH, Kondo T, Jhund PS, Comin-Colet J, de Boer RA, Desai AS, Hernandez AF, Inzucchi SE, Janssens SP, Kosiborod MN, Lam CSP, Langkilde AM, Lindholm D, Martinez F, Petersson M, Shah SJ, Thierer J, Vaduganathan M, Verma S, Wilderäng U, Claggett BC, Solomon SD, McMurray JJV
J Am Coll Cardiol 2022 Nov 1;80(18):1705-1717. Epub 2022 Aug 27 doi: 10.1016/j.jacc.2022.08.718. PMID: 36041668
SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials.
Vaduganathan M, Docherty KF, Claggett BL, Jhund PS, de Boer RA, Hernandez AF, Inzucchi SE, Kosiborod MN, Lam CSP, Martinez F, Shah SJ, Desai AS, McMurray JJV, Solomon SD
Lancet 2022 Sep 3;400(10354):757-767. Epub 2022 Aug 27 doi: 10.1016/S0140-6736(22)01429-5. PMID: 36041474
Efficacy and Safety of Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction According to Age: The DELIVER Trial.
Peikert A, Martinez FA, Vaduganathan M, Claggett BL, Kulac IJ, Desai AS, Jhund PS, de Boer RA, DeMets D, Hernandez AF, Inzucchi SE, Kosiborod MN, Lam CSP, Shah SJ, Katova T, Merkely B, Vardeny O, Wilderäng U, Lindholm D, Petersson M, Langkilde AM, McMurray JJV, Solomon SD
Circ Heart Fail 2022 Oct;15(10):e010080. Epub 2022 Aug 27 doi: 10.1161/CIRCHEARTFAILURE.122.010080. PMID: 36029467
Effect of Sacubitril/Valsartan vs Standard Medical Therapies on Plasma NT-proBNP Concentration and Submaximal Exercise Capacity in Patients With Heart Failure and Preserved Ejection Fraction: The PARALLAX Randomized Clinical Trial.
Pieske B, Wachter R, Shah SJ, Baldridge A, Szeczoedy P, Ibram G, Shi V, Zhao Z, Cowie MR; PARALLAX Investigators and Committee members
JAMA 2021 Nov 16;326(19):1919-1929. doi: 10.1001/jama.2021.18463. PMID: 34783839Free PMC Article

Recent systematic reviews

Epidemiology of heart failure in diabetes: a disease in disguise.
Hoek AG, Dal Canto E, Wenker E, Bindraban N, Handoko ML, Elders PJM, Beulens JWJ
Diabetologia 2024 Apr;67(4):574-601. Epub 2024 Feb 9 doi: 10.1007/s00125-023-06068-2. PMID: 38334818Free PMC Article
Pharmacological Treatments in Heart Failure With Mildly Reduced and Preserved Ejection Fraction: Systematic Review and Network Meta-Analysis.
Zafeiropoulos S, Farmakis IT, Milioglou I, Doundoulakis I, Gorodeski EZ, Konstantinides SV, Cooper L, Zanos S, Stavrakis S, Giamouzis G, Butler J, Giannakoulas G
JACC Heart Fail 2024 Apr;12(4):616-627. Epub 2023 Aug 30 doi: 10.1016/j.jchf.2023.07.014. PMID: 37656079
Left bundle branch area pacing in mildly reduced heart failure: A systematic literature review and meta-analysis.
Yu GI, Kim TH, Cho YH, Bae JS, Ahn JH, Jang JY, Park YW, Kwak CH
Clin Cardiol 2023 Jul;46(7):713-720. Epub 2023 May 5 doi: 10.1002/clc.24028. PMID: 37144691Free PMC Article
Sodium-glucose co-transporter 2 inhibitors in heart failure with mildly reduced or preserved ejection fraction: an updated systematic review and meta-analysis.
Wang Y, Gao T, Meng C, Li S, Bi L, Geng Y, Zhang P
Eur J Med Res 2022 Dec 29;27(1):314. doi: 10.1186/s40001-022-00945-z. PMID: 36581880Free PMC Article
Redefining the epidemiology of cardiac amyloidosis. A systematic review and meta-analysis of screening studies.
Aimo A, Merlo M, Porcari A, Georgiopoulos G, Pagura L, Vergaro G, Sinagra G, Emdin M, Rapezzi C
Eur J Heart Fail 2022 Dec;24(12):2342-2351. Epub 2022 May 16 doi: 10.1002/ejhf.2532. PMID: 35509173Free PMC Article

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