Physicians' Academy for Cardiovascular Education
Phenotype HF with midrange EF resembles HFrEF, albeit with better outcomes

Phenotype HF with midrange EF resembles HFrEF, albeit with better outcomes

News - Apr. 30, 2017

Paris, France | Heart failure with mid ejection fraction in CHARM: characteristics, outcomes and effect of candesartan across the entire EF spectrum

Presented at ESC Heart Failure 2017 by Lars LUND (Stockholm, Sweden)

Main results


These data suggest that HFmrEF resembles HFrEF with respect to most characteristics, but the clinical outcomes are better. With increasing EF, up to 50%, improvements in outcomes are seen. A significant treatment effect of candesartan as compared with placebo was seen in HFmrEF and HFrEF, but not HFpEF.

Limitations of the study include the limited statistical power at the extremes of the EF spectrum and multiple outcomes testing. Also, the common variability in EF measurements applies.

During the discussion, dr. Massimo Francesco PIEPOLI (Piacenza, IT) concluded that indeed the HFmrEF category has an intermediate character, which has prognostic value. When EF moves towards reduced EF, things are getting worse. A novelty of this study is the finding that candesartan also works at midrange EF. Dr. Piepoli did note that the patients were enrolled about 15 years ago, which may mean that their background therapy differs from today’s standard treatment.


Our coverage of ESC HF 2017 is based on the information provided during the congress.

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