{"id":"79ebafdc3930","type":"article","url":"https://hartvaat.nl/2022/12/01/langetermijnmortaliteit-bij-hfmref-systematische-review-en-meta-analyse/","title":"Langetermijnmortaliteit bij HFmrEF: systematische review en meta-analyse","title_en":"Long-term mortality in heart failure with mid-range ejection fraction: systematic review and meta-analysis.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":[],"journal":"ESC heart failure","doi":"10.1002/ehf2.14125","source_url":"https://doi.org/10.1002/ehf2.14125","authors":["Deep Chandh Raja","Indira Samarawickrema","Souvik Das","Abhinav Mehta","Lukah Tuan","Sanjiv Jain","Sanjay Dixit","Frank Marchlinski","Walter P Abhayaratna","Prashanthan Sanders","Rajeev K Pathak"],"significance":6,"published":"2022-12-01","source_date":"2022-12-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/hfmref-hartfalen-met-matig-verminderde-ejectie/","https://hartvaat.nl/kennis/hartfalen/betablokkers-bij-hartfalen/"],"congress":"","summary_en":"This meta-analysis confirmed that long-term mortality in HFmrEF is intermediate between HFrEF and HFpEF, supporting the classification of mid-range ejection fraction as a distinct prognostic category.","created":"2026-07-03T10:30:06Z","updated":"2026-07-03T13:29:11Z","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":"Meta-analyse toonde dat de langetermijnmortaliteit bij HFmrEF intermediair is tussen HFrEF en HFpEF. HFmrEF is een heterogene groep die kenmerken deelt met beide fenotypen, wat een geïndividualiseerde behandelaanpak ondersteunt.","abstract_original":"AIMS: Heart failure patients with mid-range ejection fraction (HFmrEF) have overlapping clinical features, compared with patients with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF). We aim to perform a meta-analysis of studies reporting long-term outcomes in HFmrEF compared with HFrEF and HFpEF. METHODS AND RESULTS: Data from 18 eligible large-scale studies including 126 239 patients were pooled. Patients with HFmrEF had a lower risk of all-cause death than those with HFrEF [risk ratio (RR) = 0.92; 95% CI = 0.85-0.98; P < 0.001]. This significant difference was seen in the follow-up at 1, 2, and 3 years. Patients with HFmrEF had significantly lower risk of cardiovascular (CV) deaths than HFrEF (RR = 0.77; 95% CI = 0.65-0.92; P < 0.001). Subgroup analysis showed that studies recruiting >50% of males had higher risk of deaths with HFrEF (RR = 1.15; 95% CI = 1.04-1.26; P = 0.006). When compared with HFpEF, patients with HFmrEF had comparable risk of all-cause death (RR = 1.02; 95% CI = 0.96-1.09; P = 0.53). Similarly, there were no differences in the 1, 2, and 3 year deaths; CV and non-CV deaths were insignificant between HFmrEF and HFpEF. CONCLUSIONS: The results of the study support that HFmrEF has better prognosis than HFrEF but similar prognosis when compared with HFpEF. Gender disparity between studies seems to influence the results between HFmrEF and HFrEF. Transition in left ventricular ejection fraction (LVEF), which could not be addressed in the study, may play a decisive role in determining outcomes. PROSPERO review registration number CRD42021277107."}