Heart Failure with Mid-range Ejection Fraction——a Comprehension of the Disease

Heart failure is the final main battlefield of various cardiovascular diseases with huge harm, which can cause all kinds of arrhythmias and even sudden cardiac death. The 2016 ESC guidelines formally define heart failure with mid-range ejection fraction (LVEF) in the range of 40% to 49%, aiming to refine the classification of heart failure, in order to arouse the attention of clinicians to the pathophysiology of heart failure and carry out more clinical research to better guide diagnosis and treatment. At present, there are still many controversies about the pathophysiology and treatment of HFmrEF. This article explains the characteristics of patients with HFmrEF from the aspects of epidemiology, clinical characteristics, pathophysiology, and treatment. It is found that HFmrEF is more like a transition between HFpEF and HFrEF patients than a unique phenotype. Four new drugs in the field of heart failure (ARNI, SGLT-2i, SGC, OM) and atrial septal shunts have shown different degrees of benefit in the treatment