Gaasch WH (1994) Diagnosis and treatment of heart failure based on left ventricular systolic or diastolic dysfunction. JAM 271(16):1276–80

Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay S et al (2022) AHA/ACC/HFSA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines. Circulation 145(18):e876–e894. https://doi.org/10.1161/CIR.0000000000001062

Article  PubMed  Google Scholar 

McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O et al (2022) 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 24(1):4–131. https://doi.org/10.1002/ejhf.2333

Article  PubMed  Google Scholar 

Ky B, Plappert T, Kirkpatrick J, Silvestry FE, Ferrari VA, Keane MG, Wiegers SE, Chirinos JA, StJohn Sutton M (2012) Left ventricular remodeling in human heart failure: quantitative echocardiographic assessment of 1,794 patients. Echocardiography 29(7):758–765. https://doi.org/10.1111/j.1540-8175.2012.01701.x

Article  PubMed  Google Scholar 

Bristow MR, Kao DP, Breathett KK, Altman NL, Gorcsan J 3rd, Gill EA, Lowes BD, Gilbert EM, Quaife RA, Mann DL (2017) Structural and functional phenotyping of the failing heart: is the left ventricular ejection fraction obsolete? JACC Heart Fail 5(11):772–781. https://doi.org/10.1016/j.jchf.2017.09.009

Article  PubMed  PubMed Central  Google Scholar 

Rosano GMC, Teerlink JR, Kinugawa K, Bayes-Genis A, Chioncel O, Fang J, Greenberg B, Ibrahim NE, Imamura T, Inomata T, Kuwahara K, Moura B, Onwuanyi A, Sato N, Savarese G, Sakata Y, Sweitzer N, Wilcox J, Yamamoto K, Metra M, Coats AJS. (2025) The use of left ventricular ejection fraction in the diagnosis and management of heart failure. A clinical consensus statement of the Heart Failure Association (HFA) of the ESC, the Heart Failure Society of America (HFSA), and the Japanese Heart Failure Society (JHFS). J Card Fail S1071–9164(25)00153–8. https://doi.org/10.1016/j.cardfail.2025.03.014.

Cleland JGF, Pfeffer MA, Clark AL, Januzzi JL, McMurray JJV, Mueller C, Pellicori P, Richards M, Teerlink JR, Zannad F, Bauersachs J (2021) The struggle towards a universal definition of heart failure-how to proceed? Eur Heart J 42(24):2331–2343. https://doi.org/10.1093/eurheartj/ehab082

Article  PubMed  Google Scholar 

Folse R, Braunwald E (1962) Determination of fraction of left ventricular volume ejected per beat and of ventricular end-diastolic and residual volumes. Experimental and clinical observations with a precordial dilution technic. Circulation 25:674–85

Bartle S, Sanmarco M, Dammann JJ (1965) Ejection fraction – an index of myocardial function [abstract]. Am J Cardiol 15:125

Article  Google Scholar 

Konstam MA, Abboud FM (2017) Ejection fraction: misunderstood and overrated (changing the paradigm in categorizing heart failure). Circulation 135(8):717–719. https://doi.org/10.1161/CIRCULATIONAHA.116.025795

Article  PubMed  PubMed Central  Google Scholar 

Mele D, Andrade A, Bettencourt P, Moura B, Pestelli G, Ferrari R (2020) From left ventricular ejection fraction to cardiac hemodynamics: role of echocardiography in evaluating patients with heart failure. Heart Fail Rev 25(2):217–230. https://doi.org/10.1007/s10741-019-09826-w

Article  PubMed  Google Scholar 

van de Bovenkamp AA, Nassiri S, Bakermans AJ, Burchell GL, de Man FS, van Loon RB, Handoko ML (2025) Long-term hemodynamic responses and reverse remodeling after pharmacotherapy in HFpEF versus HFrEF: a systematic review and meta-analysis. Am J Physiol Heart Circ Physiol 328(3):H419–H432. https://doi.org/10.1152/ajpheart.00544.2024

Article  CAS  PubMed  Google Scholar 

Palazzuoli A, Correale M, Iacoviello M, Gronda E (2023) Does the measurement of ejection fraction still make sense in the HFpEF framework? What recent trials suggest. J Clin Med 12(2):693. https://doi.org/10.3390/jcm12020693

Article  PubMed  PubMed Central  Google Scholar 

Cikes M, Solomon SD (2016) Beyond ejection fraction: an integrative approach for assessment of cardiac structure and function in heart failure. Eur Heart J 37(21):1642–1650. https://doi.org/10.1093/eurheartj/ehv510.

Article  PubMed  Google Scholar 

Pellikka PA, She L, Holly TA, Lin G, Varadarajan P, Pai RG, Bonow RO, Pohost GM, Panza JA et al (2018) Variability in ejection fraction measured by echocardiography, gated single-photon emission computed tomography, and cardiac magnetic resonance in patients with coronary artery disease and left ventricular dysfunction. JAMA Netw Open 1(4):e181456. https://doi.org/10.1001/jamanetworkopen.2018.1456

Article  PubMed  PubMed Central  Google Scholar 

Pickett CA, Cheezum MK, Kassop D, Villines TC, Hulten EA (2015) Accuracy of cardiac CT, radionucleotide and invasive ventriculography, two- and three-dimensional echocardiography, and SPECT for left and right ventricular ejection fraction compared with cardiac MRI: a meta-analysis. Eur Heart J Cardiovasc Imaging 16(8):848–852. https://doi.org/10.1093/ehjci/jeu313

Article  PubMed  Google Scholar 

Branca L, Sbolli M, Metra M, Fudim M (2020) Heart failure with mid-range ejection fraction: pro and cons of the new classification of heart failure by European Society of Cardiology guidelines. ESC Heart Fail 7(2):381–399. https://doi.org/10.1002/ehf2.12586

Article  PubMed  PubMed Central  Google Scholar 

Jenkins C, Moir S, Chan J, Rakhit D, Haluska B (2009) Marwick TH Left ventricular volume measurement with echocardiography: a comparison of left ventricular opacification, three-dimensional echocardiography, or both with magnetic resonance imaging. Eur Heart J 30(1):98–106. https://doi.org/10.1093/eurheartj/ehn484

Article  PubMed  Google Scholar 

Mann DL, Bristow MR (2005) Mechanisms and models in heart failure: the biomechanical model and beyond. Circulation 111(21):2837–2849

Article  PubMed  Google Scholar 

Shah KS, Xu H, Matsouaka RA, Bhatt DL, Heidenreich PA, Hernandez AF, Devore AD, Yancy CW, Fonarow GC (2017) Heart failure with preserved, borderline, and reduced ejection fraction: 5-year outcomes. J Am Coll Cardiol 70(20):2476–2486. https://doi.org/10.1016/j.jacc.2017.08.074

Article  PubMed  Google Scholar 

Triposkiadis F, Butler J, Abboud FM, Armstrong PW, Adamopoulos S, Atherton JJ, Backs J, Bauersachs J, Burkhoff D (2019) The continuous heart failure spectrum: moving beyond an ejection fraction classification. Eur Heart J 40(26):2155–2163. https://doi.org/10.1093/eurheartj/ehz158

Article  PubMed  PubMed Central  Google Scholar 

Savarese G, Vedin O, D’Amario D, Uijl A, Dahlström U, Rosano G, Lam CSP, Lund LH (2019) Prevalence and prognostic implications of longitudinal ejection fraction change in heart failure. JACC Heart Fail 7(4):306–317. https://doi.org/10.1016/j.jchf.2018.11.019

Article  PubMed  Google Scholar 

Ross J Jr. (1983) Mechanisms of cardiac contraction. What roles for preload, afterload and inotropic state in heart failure? Eur Heart J 4(Suppl A):19–28

Article  PubMed  Google Scholar 

Cohn JN, Archibald DG, Ziesche S, Franciosa JA, Harston WE, Tristani FE et al (1986) Effect of vasodilator therapy on mortality in chronic congestive heart failure. Results of a Veterans Administration Cooperative study. New Engl J Med 314:1547–52

Swedberg K, Kjekshus J (1988) Effects of enalapril on mortality in severe congestive heart failure: results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). Am J Cardiol 62:60A-A66

Article  CAS  PubMed  Google Scholar 

Yusuf S, Pitt B, Davis CE, Hood WB Jr, Cohn JN (1992) SOLVD Investigators, Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Eng J Med 327(10):685–91

Packer M, Bristow MR, Cohn JN, Colucci WS, Fowler MB, Gilbert EM, Shusterman NH (1996)  The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. U.S. Carvedilol Heart Failure study group. N Engl J Med 334(21):1349–55

Düngen HD, Apostolovic S, Inkrot S, Tahirovic E, Töpper A, Mehrhof F, Prettin C, Putnikovic B, Neskovic AN, Krotin M, Sakac D, Lainscak M, Edelmann F, Wachter R, Rau T, Eschenhagen T, Doehner W, Anker SD, Waagstein F, Herrmann-Lingen C, Gelbrich G, Dietz R (2011) CIBIS-ELD investigators and Project multicentre trials in the competence network heart failure. Titration to target dose of bisoprolol vs. carvedilol in elderly patients with heart failure: the CIBIS-ELD trial. Eur J Heart Fail 13(6):670–80. https://doi.org/10.1093/eurjhf/hfr020

Nicolosi GL, Latini R, Marino P, Maggioni AP, Barlera S, Franzosi MG, Geraci E, Santoro L, Tavazzi L, Tognoni G, Vecchio C, Volpi A, Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (1996) The prognostic value of predischarge quantitative two-dimensional echocardiographic measurements and the effects of early lisinopril treatment on left ventricular structure and function after acute myocardial infarction in the GISSI-3 trial. Eur Heart J 17(11):1646–1656

Article  CAS  PubMed  Google Scholar 

Rohde LE, Vaduganathan M, Claggett BL, Polanczyk CA, Dorbala P, Packer M, Desai AS, Zile M, Rouleau J, Swedberg K, Lefkowitz M, Shi V, McMurray JJV, Solomon SD (2021) Dynamic changes in cardiovascular and systemic parameters prior to sudden cardiac death in heart failure with reduced ejection fraction: a PARADIGM-HF analysis. Eur J Heart Fail 23(8):1346–1356. https://doi.org/10.1002/ejhf.2120

Article  PubMed  Google Scholar 

Fiuzat M, Ezekowitz J, Alemayehu W, Westerhout CM, Sbolli M, Cani D, Whellan DJ, Ahmad T, Adams K, Piña IL, Patel CB, Anstrom KJ, Cooper LS, Mark D, Leifer ES, Felker GM, Januzzi JL, O’Connor CM (2020) Assessment of limitations to optimization of guideline-directed medical therapy in heart failure from the GUIDE-IT trial: a secondary analysis of a randomized clinical trial. JAMA Cardiol 5(7):757–764. https://doi.org/10.1001/jamacardio.2020.0640

Article  PubMed  Google Scholar 

Christersson M, Gustafsson S, Lampa E, Almstedt M, Cars T, Bodegård J et al (2024) Usefulness of heart failure categories based on left ventricular ejection fraction. J Am Heart Assoc 13:e032257. https://doi.org/10.1161/JAHA.123.032257

Article  PubMed  PubMed Central  Google Scholar 

Reddy YNV, Carter RE, Obokata M, Redfield MM (2018) Borlaug BAA Simple, evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction. Circulation 138(9):861–870. https://doi.org/10.1161/CIRCULATIONAHA.118.034646

Article  PubMed  PubMed Central