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Current Advances and Future Perspectives of Heart Failure with Mildly...
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Current Advances and Future Perspectives of Heart Failure with Mildly Reduced or Preserved Ejection Fraction

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (30 April 2025) | Viewed by 1348

Special Issue Editor

Dr. Johanna Paola Contreras

E-Mail Website
Guest Editor
Department of Cardiology, Mount Sinai Health System, New York, NY 10029, USA
Interests: cardiomyopathy; echocardiography; heart disease; metabolic syndrome; myocarditis; obesity; pulmonary hypertension

Special Issue Information

Dear Colleagues,

During the past decades, significant improvements in the management of heart failure have been achieved. The introduction of new therapies for congestive heart failure has improved outcomes and mortality worldwide. One promising research area is that of Heart Failure with Mildly Reduced (HFmrEF) or Preserved Ejection Fraction (HFpEF), with new therapies like SGLT-2 (Sodium glucose Cotransporter 2) inhibitors, MRAs (Mineralocorticoid Receptor Antagonists), among other therapies. Additionally, there is emerging evidence of the existence of different phenotypes of HFpEF, and an emphasis on the importance of managing comorbidities in such patients, such as atrial firbillation, coronary artery disease, and diabetes. Thus, the prospect for this growing field of HFpEF management is promising, but there is still much to do. In this Special Issue, we welcome authors to submit papers addressing current advances and future perspectives as well as knowledge gaps in the area of Heart Failure with Mildly Reduced or Preserved Ejection Fraction.

Dr. Johanna Paola Contreras
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiology
  • heart failure
  • heart failure with preserved ejection fraction
  • heart failure with mildly reduced ejection fraction
  • HFpEF
  • HFmrEF

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Published Papers (1 paper)

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Research

17 pages, 867 KiB  
Article
Supra-Normal Ejection Fraction at Hospital Admission Stratifies Mortality Risk in HFpEF Patients Aged ≥ 70 Years
by Andrea Sonaglioni, Chiara Lonati, Valentina Scime’, Gian Luigi Nicolosi, Antonino Bruno, Michele Lombardo and Sergio Harari
J. Clin. Med. 2025, 14(2), 426; https://doi.org/10.3390/jcm14020426 - 10 Jan 2025
Viewed by 1027
Abstract
Background: During the last few years, significant pathophysiological differences between heart failure (HF) patients with “normal” ejection fraction (EF) (50% to 64%) and those with supra-normal EF (≥65%) have been highlighted. However, these distinct EF phenotypes have been poorly investigated in elderly patients [...] Read more.
Background: During the last few years, significant pathophysiological differences between heart failure (HF) patients with “normal” ejection fraction (EF) (50% to 64%) and those with supra-normal EF (≥65%) have been highlighted. However, these distinct EF phenotypes have been poorly investigated in elderly patients aged ≥70 y. Accordingly, the present study aimed at assessing the clinical and echocardiographic characteristics of a retrospective cohort of elderly HFpEF patients (aged ≥ 70 y), categorized on the basis of “normal” EF (50 to 64%) or “supra-normal” EF (≥65%). Methods: All patients aged ≥ 70 y that were discharged from our Institution with a first diagnosis of HF with preserved EF (HFpEF) between January 2020 and March 2021 entered the study. All patients underwent clinical evaluation, blood tests, and transthoracic echocardiography. The primary endpoint was “all-cause mortality”, while the secondary one was the composite “all-cause mortality or rehospitalization for all causes” over a mid-term follow-up. Results: A total of 200 HFpEF patients (86.4 ± 6.6 y, 70% females) were retrospectively evaluated. The “normal” EF group (n = 99) and the “supra-normal” EF one (n = 101) were separately analyzed. Compared to patients with “normal” EF, those with “supra-normal” EF were older, with greater comorbidity burden, and moderate-to-severe frailty status. The mean follow-up duration was 3.6 ± 0.3 y. During follow-up, 79 patients died, and 73 were rehospitalized. In the multivariate Cox regression analysis, age (HR 1.09, 95% CI 1.03–1.16, p = 0.002), EF (HR 1.08, 95% CI 1.03–1.14, p = 0.004), tricuspid annular plane systolic excursion (TAPSE)/systolic pulmonary artery pressure (sPAP) ratio (HR 0.14, 95% CI 0.03–0.61, p = 0.009), and infectious disease occurring during the baseline stay (HR 7.23, 95% CI 2.41–21.6, p < 0.001) were independently associated with the primary endpoint in the whole study population. EF (HR 1.04, 95% CI 1.01–1.07, p = 0.02) also predicted the secondary endpoint. EF ≥65% was the best cut-off to predict both endpoints. Conclusions: “Supra-normal” EF (≥65%) at hospital admission is independently associated with all-cause mortality and rehospitalization for all causes in elderly HFpEF patients over a mid-term follow-up. Full article
(This article belongs to the Special Issue Current Advances and Future Perspectives of Heart Failure with Mildly Reduced or Preserved Ejection Fraction)
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