HFrecEF – HF with recovered EF

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HFrecEF – HF with recovered EF

Classification of heart failure is ever changing. We had heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Then came heart failure with mid range ejection fraction (HFmrEF) with ejection fraction between 40 and 50%.

Yet another entity is heart failure with recovered ejection fraction (HFrecEF) [1]. Over half of patients with history of heart failure and left ventricular ejection fraction above 50% have HFrecEF. It has a better prognosis than HFrEF and HFpEF, but is likely to be mistook for the latter. They are less likely to die or require ventricular assist devices or cardiac transplantation. Chances of hospitalization are also lesser. All the same, it is not a benign entity and requires ongoing cardioprotective therapy as they have evidence of persistent neurohormonal activation, oxidative stress and cardiomyocyte injury [2].


  1. Basuray A, French B, Ky B, Vorovich E, Olt C, Sweitzer NK, Cappola TP, Fang JC. Heart failure with recovered ejection fraction: clinical description, biomarkers, and outcomes. Circulation. 2014 Jun 10;129(23):2380-7.
  2. Marwick TH. Ejection Fraction Pros and Cons: JACC State-of-the-Art Review. J Am Coll Cardiol. 2018 Nov 6;72(19):2360-2379.