Table 11

Heart failure phenotypes323

HFpEFHFmrEFHFrEF
Criterion 1Symptoms and/or signsaSymptoms and/or signsaSymptoms and/or signsa
Criterion 2LVEF ≥50%LVEF 40–49%LVEF <40%
Criterion 31. Elevated natriuretic peptidesb1. Elevated natriuretic peptidesbNone
2. At least one additional criterion:2. At least one additional criterion: 
a) structural heart disease (i.e. LVH and/or LAE)a) structural heart disease (i.e. LVH and/or LAE) 
b) diastolic dysfunctioncb) diastolic dysfunctionc 
HFpEFHFmrEFHFrEF
Criterion 1Symptoms and/or signsaSymptoms and/or signsaSymptoms and/or signsa
Criterion 2LVEF ≥50%LVEF 40–49%LVEF <40%
Criterion 31. Elevated natriuretic peptidesb1. Elevated natriuretic peptidesbNone
2. At least one additional criterion:2. At least one additional criterion: 
a) structural heart disease (i.e. LVH and/or LAE)a) structural heart disease (i.e. LVH and/or LAE) 
b) diastolic dysfunctioncb) diastolic dysfunctionc 

HF = heart failure; HFmrEF = heart failure with mid-range ejection fraction; HFpEF = heart failure with preserved ejection fraction; HFrEF = heart failure with reduced ejection fraction; LAE = left atrial enlargement; LVEF = left ventricular ejection fraction; LVH = left ventricular hypertrophy; NT-proBNP = N-terminal pro-B-type natriuretic peptide.

a

Signs may not be present at an early stage or in patients receiving diuretics.

b

Elevation of B-type natriuretic peptide ≥35 pg/mL and/or NT-proBNP ≥125 pg/mL.

c

For example, E/e′ ≥13, and a mean e’ septal and lateral wall <9 cm/s on echocardiography.

Table 11

Heart failure phenotypes323

HFpEFHFmrEFHFrEF
Criterion 1Symptoms and/or signsaSymptoms and/or signsaSymptoms and/or signsa
Criterion 2LVEF ≥50%LVEF 40–49%LVEF <40%
Criterion 31. Elevated natriuretic peptidesb1. Elevated natriuretic peptidesbNone
2. At least one additional criterion:2. At least one additional criterion: 
a) structural heart disease (i.e. LVH and/or LAE)a) structural heart disease (i.e. LVH and/or LAE) 
b) diastolic dysfunctioncb) diastolic dysfunctionc 
HFpEFHFmrEFHFrEF
Criterion 1Symptoms and/or signsaSymptoms and/or signsaSymptoms and/or signsa
Criterion 2LVEF ≥50%LVEF 40–49%LVEF <40%
Criterion 31. Elevated natriuretic peptidesb1. Elevated natriuretic peptidesbNone
2. At least one additional criterion:2. At least one additional criterion: 
a) structural heart disease (i.e. LVH and/or LAE)a) structural heart disease (i.e. LVH and/or LAE) 
b) diastolic dysfunctioncb) diastolic dysfunctionc 

HF = heart failure; HFmrEF = heart failure with mid-range ejection fraction; HFpEF = heart failure with preserved ejection fraction; HFrEF = heart failure with reduced ejection fraction; LAE = left atrial enlargement; LVEF = left ventricular ejection fraction; LVH = left ventricular hypertrophy; NT-proBNP = N-terminal pro-B-type natriuretic peptide.

a

Signs may not be present at an early stage or in patients receiving diuretics.

b

Elevation of B-type natriuretic peptide ≥35 pg/mL and/or NT-proBNP ≥125 pg/mL.

c

For example, E/e′ ≥13, and a mean e’ septal and lateral wall <9 cm/s on echocardiography.

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