{"id":"80f588ba782d","type":"article","url":"https://hartvaat.nl/2018/08/01/kenmerken-en-prognose-van-hfmref-versus-hfref-en-hfpef-langetermijn/","title":"Kenmerken en prognose van HFmrEF versus HFrEF en HFpEF: langetermijn","title_en":"Characteristics and long-term prognosis of patients with heart failure and mid-range ejection fraction compared with reduced and preserved ejection fraction: a systematic review and meta-analysis.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":[],"journal":"ESC heart failure","doi":"10.1002/ehf2.12283","source_url":"https://doi.org/10.1002/ehf2.12283","authors":["Josephine Lauritsen","Finn Gustafsson","Jawdat Abdulla"],"significance":6,"published":"2018-08-01","source_date":"2018-08-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/hfmref-hartfalen-met-matig-verminderde-ejectie/"],"congress":"","summary_en":"This meta-analysis compared the clinical characteristics and long-term prognosis of HFmrEF with HFrEF and HFpEF, positioning the intermediate ejection fraction category and its distinct prognostic profile.","created":"2026-07-03T10:27:24Z","updated":"2026-07-03T13:26:38Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Vergelijking van langetermijnkenmerken en prognose van patiënten met HFmrEF versus HFrEF en HFpEF. Positioneert de intermediaire categorie.","abstract_original":"AIMS: This study aimed to assess by a meta-analysis the clinical characteristics, all-cause and cardiovascular mortality, and hospitalization of patients with heart failure (HF) with mid-range ejection fraction (HFmrEF) compared with HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). METHODS AND RESULTS: Data from 12 eligible observational studies including 109 257 patients were pooled. HFmrEF patients were significantly different and occupied a mid-position between HFrEF and HFpEF: mean age 73.6 ± 9.8 vs. 72.6 ± 9.8 and 77.6 ± 7.2 years, male gender 59% vs. 68.5% and 40%, ischaemic heart disease 49% vs. 52.6% and 39.4%, hypertension 67.3% vs. 61.5% and 76.5%, atrial fibrillation 45.2% vs. 39.6% and 46%, chronic obstructive pulmonary disease 26.4% vs. 24.9% and 30.5%, estimated glomerular filtration rate 62 ± 30 vs. 63.3 ± 23 and 59 ± 22.5, use of renin-angiotensin system inhibitors 79.6% vs. 90.1% and 68.7%, beta-blockers 82% vs. 89% and 73.5%, and aldosterone antagonists 20.3 vs. 31.5% and 26%, P-values < 0.05. After a mean follow-up of 31 ± 5 months, all-cause mortality was significantly lower in HFmrEF than in HFrEF and HFpEF (26.8% vs. 29.5% and 31%): risk ratio (RR) 0.95 [0.93-0.98; 95% confidence interval (CI)], P < 0.001, and 0.97 (0.94-0.99; 95% CI), P = 0.014, respectively. Cardiovascular mortality was lowest in HFmrEF (9.7% vs. 13% and 12.8%): RR = 0.81 (0.73-0.91), P < 0.001, and 1.10 (0.97-1.24; 95% CI), P = 0.13, respectively. HF hospitalization in HFmrEF compared to that in HFrEF and HFpEF was 23.9% vs. 27.6% and 23.3% with RR = 0.89 (0.85-0.93), P < 0.001, and RR = 1.12 (1.07-1.17), P < 0.001, respectively. CONCLUSIONS: The results of this study support that HFmrEF is a distinct category characterized by a mid-position between HFrEF and HFpEF and with the lowest all-cause and cardiovascular mortality."}