{"id":128918,"date":"2023-01-09T16:27:45","date_gmt":"2023-01-09T16:27:45","guid":{"rendered":"https:\/\/ccs.ca\/?post_type=guideline&#038;p=128918"},"modified":"2023-04-12T04:59:06","modified_gmt":"2023-04-12T04:59:06","slug":"chapter-2-definition-of-hf","status":"publish","type":"guideline","link":"https:\/\/ccs.ca\/guideline\/2017-heart-failure-management-of-hf\/chapter-2-definition-of-hf\/","title":{"rendered":"2. Definition of HF"},"content":{"rendered":"\n<p>HF is a complex clinical syndrome in which abnormal heart function results in, or increases the subsequent risk of,<\/p>\n\n\n\n<ul><li>HF with reduced ejection fraction (HFrEF): LVEF \u2264 40%.<\/li><\/ul>\n\n\n\n<p>This recognizes the uncertainty that often occurs in the measurement of LVEF, the evolving landscape of current clinical trials enrolling patients with different LVEF cutoffs, and evolving ways to evaluate cardiac function. Echocardiography is the most accessible method to evaluate LVEF in Canada. Estimates of ejection fraction (EF) might vary because of patient or technical factors, as well as therapy or clinical deterioration. The previously stated EF cut points recognize that there is a large body of evidence related to treatment for patients with HFrEF and emerging evidence for patients with HFpEF and HFmEF. HFmEF might represent many different phenotypes, including patients transitioning to and from HFpEF. The term \u201crecovered EF\u201d has also been added to the literature,<sup><a href=\"#citation-5\">[5]<\/a><\/sup> referring to patients who previously had HFrEF and now have an EF &gt; 40%. These patients might eventually be classified in the HFmEF or HFpEF group but deserve recognition because despite their recovered imaging parameters, they might still carry additional risk for adverse clinical events. Uncertainty exists on strategies for management of individuals with HFmEF including surveillance, treatment, and prognosis.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" class=\"wp-block-heading\" id=\"2-1-ejection-fraction-terminology\">2.1 Ejection fraction terminology<\/h2>\n\n\n\n<p>This guideline uses the following terms:<\/p>\n\n\n\n<ul><li>HF with preserved ejection fraction (HFpEF): LV ejection fraction (LVEF) \u2265 50%;<\/li><li>HF with a mid-range ejection fraction (HFmEF): LVEF 41%-49%;<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\" class=\"wp-block-heading\" id=\"2-2-symptoms-terminology\">2.2 Symptoms terminology<\/h2>\n\n\n\n<p>Symptoms are described using the New York Heart Association (NYHA) functional class I-IV (Table 1).<\/p>\n\n\n<div id=\"references-block_63bc868d13e40\" class=\"references-block\">\n    <h2 class=\"title\" class=\"title\" id=\"references\">References<\/h2>    <p class=\"content\"><p>5. Kalogeropoulos AP, Fonarow GC, Georgiopoulou V, et al. Characteristics and outcomes of adult outpatients with heart failure and improved or recovered ejection fraction. JAMA Cardiol 2016;1:510-8.<\/p>\n<\/p><\/div>\n","protected":false},"featured_media":0,"parent":127416,"menu_order":4,"template":"guideline-chapter.php","topic":[],"resource_type":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>2. Definition of HF - Canadian Cardiovascular Society<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/ccs.ca\/guideline\/2017-heart-failure-management-of-hf\/chapter-2-definition-of-hf\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"2. 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