🫁 HFrEF vs HFpEF Classification Simulator

Measuring Ejection Fraction — the Splitting Criterion

Echocardiographic EF separates heart failure into distinct phenotypes.

• ≥55%: Normal EF (placeholder reference range)
• <40%: HFrEF cutoff (placeholder threshold)
• 40–49%: HFmrEF range (placeholder threshold)
• ≥50%: HFpEF cutoff (placeholder threshold)

How EF is measured

Placeholder: EF is estimated via echo Simpson biplane method.

HFrEF — The Dilated, Weakly Contracting Ventricle

Chamber dilation and reduced contractility define systolic failure.

• Dilated: Chamber size (placeholder finding)
• Thin: Wall thickness (placeholder finding)
• Reduced: Contractility (placeholder finding)
• Ischemic: Common cause (placeholder etiology)

Mechanism of systolic failure

Placeholder: remodeling and dilation reduce stroke volume output.

HFpEF — The Stiff, Poorly Filling Ventricle

Concentric hypertrophy and stiffness impair diastolic filling.

• Normal/small: Chamber size (placeholder finding)
• Thick: Wall thickness (placeholder finding)
• Impaired: Relaxation (placeholder finding)
• Hypertension: Common cause (placeholder etiology)

Mechanism of diastolic failure

Placeholder: stiff myocardium raises filling pressures despite normal EF.

Diagnostic Criteria — HFrEF vs HFpEF

Diagnosis blends EF cutoffs, biomarkers, and structural imaging.

• Elevated both: BNP/NT-proBNP (placeholder biomarker)
• Echo + E/e': Key imaging (placeholder criterion)
• H2FPEF: HFpEF score (placeholder tool)
• MAGGIC: HFrEF score (placeholder tool)

Differentiating work-up

Placeholder: combines EF, natriuretic peptides, and diastolic indices.

Treatment Approach — Diverging Therapy Pathways

Evidence-based GDMT is robust in HFrEF, limited in HFpEF.

• 4 pillars: HFrEF GDMT (placeholder regimen)
• SGLT2i: HFpEF mainstay (placeholder regimen)
• Both groups: Diuretics (placeholder use)
• HFrEF > HFpEF: Mortality benefit (placeholder outcome)

Therapy selection logic

Placeholder: drug classes chosen based on EF and comorbidities.

Placeholder key insight: phenotype determines evidence-based therapy choice.