About this Research Topic

Background

In 2013, The American Heart Association (AHA)/American College of Cardiology (ACC) assigned an ejection fraction (EF) range to heart failure with reduced ejection fraction (HFrEF, EF ≤ 40%), heart failure with preserved ejection fraction (HFpEF, EF ≥50%), and heart failure with mid-range ejection fraction (HFmrEF, between 41% and 49%). HFpEF patients have severe symptoms of exercise intolerance, poor quality-of-life, frequent hospitalizations, and increased mortality. HFpEF was originally viewed as a disorder due to solely abnormalities in left ventricular diastolic function, which is now understood as a systemic syndrome involving multiple organ systems, likely triggered by inflammation and important contribution of aging, lifestyle factors, genetic predisposition, and multiple-comorbidities. HFmrEF patients represent a group with heterogeneous clinical characteristics that at times resembles HFrEF, other times resembles HFpEF, while at others resembles a unique phenotype altogether.

With the ongoing struggle for finding effective therapies for patients with HFpEF, a specific focus on and inclusion of patients with HFmrEF may lead to a better understanding of HFpEF and more promising therapeutic options. Like different sides of the same coin, clinically, HFmrEF shares features of both HFpEF and HFrEF, while HFmrEF cannot be simply understood as a transition between HFpEF and HFrEF.

GWTG-HF, OPTIMIZE-HF, TIME-CHF, ADHERE, CHARM, TOPACT, PARAGON-HF trials have reported clinical characteristics, pathophysiology, prognosis, management of HFmrEF and HFpEF patients, but the results are inconsistent, with pathology and therapeutic approaches of HFmrEF and HFpEF remain poorly understood.

In this Research Topic, we seek to provide a forum for recent advances on pathobiology, pathophysiology, mechanism, diagnosis, management, and prognosis of HFmrEF and HFpEF.

Potential topics include but are not limited to the following:
1) Molecular and cellular pathobiology and pathophysiology of HFmrEF or HFpEF.
2) Novel diagnostic strategies on HFmrEF or HFpEF.
3) Novel treatment strategies on HFmrEF or HFpEF.
4) Clinical studies with a focus on HFmrEF or HFpEF: diagnosis, molecular signaling and cellular mechanisms, and treatment strategy.
5) Experimental and clinical research on HFmrEF or HFpEF.

Keywords: HFmrEF, HFpEF, pathobiology, diagnosis, treatment

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