Publication: Characteristics and clinical outcomes of patients with acute heart failure with a supranormal left ventricular ejection fraction

Heart failure with a supranormal ejection fraction (HFsnEF) is defined as a left ventricular ejection fraction >65%. Recent reports have found that this group of patients have worse clinical outcome and attenuated treatment effect, but no clinical data is available in acute heart failure. The RELAXin in Acute Heart Failure 2 (RELAX-AHF 2) provided an excellent cohort to study this interesting group of patients. The study was performed by B.J. van Essen under the supervision of prof. dr. A.A. Voors.

Proportion of 180-day all-cause, cardiovascular and non-cardiovascular mortality by heart failure subgroup. The numbers inside the bars reflect the absolute number of events per category.


– The prevalence of patients with HFsnEF was low (only 2.5% had a supranormal ejection fraction)
– Patients with HFsnEF were more often women, had a higher prevalence of non-ischemic HF and lower levels of natriuretic peptides
– Cardiovascular mortality was highest in HFrEF, whereas death from non-cardiovascular causes was significantly higher in patients with HFsnEF

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