Heart failure with normal ejection fraction

Heart failure with normal ejection fraction (HFNEF) is the most prevalent form of heart failure, and knowledge of HFNEF in the last decade has grown worldwide. Physicians have always viewed with suspicion the possibility of heart failure being present in patients with normal ejection fraction. Although HFNEF and heart failure with reduced ejection fraction (HFREF) share the same symptoms in relation to other parameters, such as the mode of left ventricular remodeling, HFNEF and HFREF reveal different behaviors. The diagnosis of HFNEF involves the presence of signs or symptoms of heart failure, left ventricle ejection fraction >= 50%, and diastolic dysfunction assessed by tissue Doppler imaging and/or measurement of biomarkers. Drugs that have produced clear improvements in HFREF have not produced similar beneficial effects in HFNEF. The future of clinical research should separate HFNEF and HFREF, in order to better understand their unique mechanisms of disease and optimal treatment strategies.