Chronic heart failure with supranormal left ventricular ejection fraction

1. Gebhard C, Maredziak M, Messerli M, Buechel RR, Lin F, Gransar H et al. Increased long-term mortality in women with high left ventricular ejection fraction: Data from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) long-term registry. Eur Heart J Cardiovasc Imaging. 2020;21(4):363–74.

PMID: 31985803. PMCID: PMC7778362. https://doi.org/10.1093/ehjci/jez321

2. Wehner GJ, Jing L, Haggerty CM, Suever JD, Leader JB, Hartzel DN et al. Routinely reported ejection fraction and mortality in clinical practice: Where does the nadir of risk lie? Eur Heart J. 2020;41(12):1249–57.

PMID: 31386109. PMCID: PMC8204658. https://doi.org/10.1093/eurheartj/ehz550

3. Brener MI, Borlaug BA, Burkhoff D. HF?EF: The mysterious relationship between heart failure and ejection fraction continues. Circulation. 2022;146(7):519–22.

PMID: 35969653. https://doi.org/10.1161/circula-tionaha.122.060540

4. Качнов В.А., Тыренко В.В., Кольцов А.В., Бологов С.Г., Коцоева О.Т. Новый фенотип пациента с сердечной недостаточностью со «сверхнормальной фракцией выброса левого желудочка». Кардиологический вестник. 2023;18(3-1):16–22. (Kachnov VA, Tyrenko VV, Koltsov AV, Bologov SG, Kotsoeva OT. New phenotype of a patient with heart failure and “supra-normal left ventricular ejection fraction”. Kardiologicheskiy vestnik = Russian Cardiology Bulletin. 2023;18(3-1):16–22 (In Russ.)).

EDN: NDCNIW. https://doi.org/10.17116/Cardiobulletin20231803116

5. Гаврюшина С.В., Агеев Ф.Т. Сердечная недостаточность с сохраненной фракцией выброса левого желудочка: эпидемиология, «портрет» больного, клиника, диагностика. Кардиология. 2018;58(S4):55–64. (Gavryushina SV, Ageev FT. Heart failure with preserved left ventricular ejection fraction: Epidemiology, patient “portrait”, clinic, and diagnostics. Kardiologiya = Cardiology. 2018;58(S4):55–64 (In Russ.)).

EDN: XMGUCD. https://doi.org/10.18087/cardio.2467

6. Беленков Ю.Н., Мареев В.Ю., Агеев Ф.Т., Фомин И.В., Бадин Ю.В., Поляков Д.С. с соавт. Истинная распространенность ХСН в Европейской части Российской Федерации (исследование ЭПОХА, госпитальный этап). Журнал сердечная недостаточность. 2011;12(2):63–68. (Belenkov YuN, Mareev VYu, Ageev FT, Fomin IV, Badin YuV, Polyakov DS et al. Veritable prevalence of CHF in the European part of Russian Federation (EPOCHA trial, hospital stage). Zhurnal serdechnaya nedostatochnost’ = Russian Heart Failure Journal. 2011;12(2):63–68 (In Russ.)). EDN: OZDQTR.

7. Кольцов А.В., Тыренко В.В. Регистр пациентов, страдающих сердечной недостаточностью, в г. Санкт-Петербурге «ПЕРСОНА-ХСН»: промежуточные результаты. Вестник Российской военно-медицинской академии. 2023;25(4):595–602. (Koltsov AV, Tyrenko VV. The register of patients suffering from heart failure in St. Petersburg “PERSONA-CHF”: Interim results. Vestnik Rossiiskoy voenno-meditsinskoy akademii = Bulletin of The Russian Military Medical Academy. 2023;25(4):595–602 (In Russ.)).

EDN: FMWXRI. https://doi.org/10.17816/brmma562963

8. Imamura T, Hida Y, Ueno H, Kinugawa K, Yashima F, Tada N et al.; On behalf of the Ocean-Tavi investigators. Clinical implication of supra-normal left ventricular ejection fraction in patients undergoing transcatheter aortic valve replacement. J Clin Med. 2023;12(23):7429.

PMID: 38068484. PMCID: PMC10706870. https://doi.org/10.3390/jcm12237429

9. Segev A, Ishay RT-B, Metra M et al. Heart failure with supranormal ejection fraction: Clinical characteristics and outcomes compared to mildly reduced and preserved ejection fraction. Clin Res Cardiol. 2025;114(5):665–75.

PMID: 39992387. PMCID: PMC12058924. https://doi.org/10.1007/s00392-025-02620-9

10. Gotsman I, Leibowitz D, Keren A, Amir O, Zwas DR. Echocardiographic characteristics and clinical outcomes of the hyperdynamic heart: A ‘super-normal’ heart is not a normal heart. Am J Cardiol. 2023;187:119–26.

PMID: 36459734. https://doi.org/10.1016/j.amjcard.2022.10.029

11. Stępien K, Eliasz K, Nowak K, Karcinska A, Kachnic N, Yika ADC et al. Clinical determinants and long-term survival in heart failure with supra-normal ejection fraction. Insights from LECRA-HF registry. Adv Med Sci. 2025;70(1):166–71.

PMID: 39983867. https://doi.org/10.1016/j.advms.2025.02.005

12. Landucci L, Faxén UL, Benson L, Rosano GMC, Dahlström U, Lund LH, Savarese G. Characterizing heart failure across the spectrum of the preserved ejection fraction: Does heart failure with supranormal ejection fraction exist? Data from the Swedish heart failure registry. J Am Heart Assoc. 2025;14(6):e037502.

PMID: 40079278. https://doi.org/10.1161/jaha.124.037502

13. Stewart S, Playford D, Scalia GM, Currie P, Celermajer DS, Prior D et al.; NEDA Investigators. Ejection fraction and mortality: A nationwide register-based cohort study of 499 153 women and men. Eur J Heart Fail. 2021;23(3):406–16.

PMID: 33150657. https://doi.org/10.1002/ejhf.2047

14. Ohte N, Kikuchi S, Iwahashi N, Kinugasa Y, Dohi K, Takase H et al.; EASY HFpEF investigators. Distinctive left ventricular-arterial and right ventricular-pulmonary arterial coupling observed in patients with heart failure and a higher left ventricular ejection fraction range. Eur Heart J Cardiovasc Imaging. 2024;25(6):774–81.

PMID: 38284416. https://doi.org/10.1093/ehjci/jeae033

15. Maredziak M, Bengs S, Portmann A, Haider A, Wijnen WJ, Warnock GI et al. Microvascular dysfunction and sympathetic hyperactivity in women with supra-normal left ventricular ejection fraction (snLVEF). Eur J Nucl Med Mol Imaging. 2020;47(13):3094–3106.

PMID: 32506162. https://doi.org/10.1007/s00259-020-04892-x

16. Kondo T, Dewan P, Anand IS, Desai AS, Packer M, Zile MR et al. Clinical characteristics and outcomes in patients with heart failure: Are there thresholds and inflection points in left ventricular ejection fraction and thresholds justifying a clinical classification? Circulation. 2023;148(9):732–49.

PMID: 37366061. https://doi.org/10.1161/circulationaha.122.063642

17. Витт К.Н., Кужелева Е.А., Тукиш О.В., Солдатенко М.В., Кондратьев М.Ю., Огуркова О.Н. с соавт. Низкоинтенсивное воспаление как проявление коморбидности и фактор неблагоприятного клинического течения сердечной недостаточности с сохраненной фракцией выброса. Кардиоваскулярная терапия и профилактика. 2024;23(2):35–43. (Vitt KN, Kuzheleva EA, Tukish OV, Soldatenko MV, Kondratiev MYu, Ogurkova ON et al. Lowintensity inflammation as a manifestation of comorbidity and a factor in the unfavorable clinical course of heart failure with preserved ejection fraction. Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular Therapy and Prevention. 2024;23(2):35–43 (In Russ.)).

EDN: FEZEBR. https://doi.org/10.15829/1728-8800-2024-3847

18. Ono R, Falcão LM. Supra-normal left ventricular function. Am J Cardiol. 2023;207:84−92.

PMID: 37734305. https://doi.org/10.1016/j.amjcard.2023.08.169

19. Huang Z, Jiang Y, Zhou Y. Heart failure with supra-normal left ventricular ejection fraction – state of the art. Arq Bras Cardiol. 2021;116(5):1019–22.

PMID: 34008831. PMCID: PMC8121464. https://doi.org/10.36660/abc.20190835

20. Hegi B, Hernandez JM, Ko CY, Hong J, Shen EY, Spencer ER et al. Diabetes and excess aldosterone promote heart failure with preserved ejection fraction. J Am Heart Assoc. 2022;11(23):e027164.

PMID: 36416174. PMCID: PMC9851441. https://doi.org/10.1161/jaha.122.027164

21. Forrest IS, Rocheleau G, Bafna S, Argulian E, Narula J, Natarajan P, Do R. Genetic and phenotypic profiling of supranormal ejection fraction reveals decreased survival and underdiagnosed heart failure. Eur J Heart Fail. 2022;24(11):2118–27.

PMID: 35278270. PMCID: PMC9464795. https://doi.org/10.1002/ejhf.2482

22. Юпатов В.Д., Кароли Н.А. Одышка у пациентов с сердечно-сосудистыми заболеваниями: клинико-диагностические и патофизиологические аспекты. Южно-Российский журнал терапевтической практики. 2024;5(4):6–14. (Yupatov VD, Karoli NA. Dyspnea in patients with cardiovascular diseases: Clinical, diagnostic and pathophysiologic aspects. Yuzhno-Rossiyskiy zhurnal terapevticheskoy praktiki = South Russian Journal of Therapeutic Practice. 2024;5(4):6–14 (In Russ.)).

EDN: AAIMWR. https://doi.org/10.21886/27128156-2024-5-4-6-14

23. Павлюкова Е.Н., Кужель Д.А. Сердечная недостаточность с сохраненной фракцией выброса левого желудочка: роль диастолического стресс-теста в алгоритмах диагностики. Российский кардиологический журнал. 2021;26(2):96–102. (Pavlyukova EN, Kuzhel DA. Heart failure with preserved ejection fraction: The role of diastolic stress test in diagnostic algorithms. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2021;26(2):96–102 (In Russ.)).

EDN: ZJMVXW. https://doi.org/10.15829/1560-4071-2021-4147

24. Мареев В.Ю., Гарганеева А.А., Агеев Ф.Т., Арутюнов Г.П., Беграмбекова Ю.Л., Беленков Ю.Н. с соавт. Экспертное мнение по применению диуретиков при хронической сердечной недостаточности. Общество специалистов по сердечной недостаточности. Кардиология. 2020;60(12):13–47. (Mareev VYu, Garganeeva AA, Ageev FT, Arutyunov GP, Begrambekova YuL, Belenkov YuN et al. The use of diuretics in chronic heart failure. Position paper of the Russian Heart Failure Society. Kardiologiya = Cardiology. 2020;60(12):13–47 (In Russ.)).

EDN: GIGGNS. https://doi.org/10.18087/cardio.2020.12.n1427

25. van Essen BJ, Tromp J, Maaten JMT, Greenberg BH, Gimpelewicz C, Felker GM et al. Characteristics and clinical outcomes of patients with acute heart failure with a supranormal left ventricular ejection fraction. Eur J Heart Fail. 2023;25(1):35–42.

PMID: 36114655. PMCID: PMC10092799. https://doi.org/10.1002/ejhf.2695

26. Reddy YNV, Carter RE, Obokata M, Redfield MM, Borlaug BA. A simple, evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction. Circulation. 2018;138(9):861–70.

PMID: 29792299. PMCID: PMC6202181. https://doi.org/10.1161/circulationaha.118.034646

27. Мареев Ю.В., Гарганеева А.А., Тукиш О.В., Реброва Т.Ю., Аникина Д.В., Мареев В.Ю. Сложности в диагностике сердечной недостаточности с сохраненной фракцией выброса в реальной клинической практике: диссонанс между клиникой, эхокардиографическими изменениями, величиной натрийуретических пептидов и шкалой H2FPEF. Кардиология. 2019;59(S12):37–45. (Mareev YuV, Garganeeva AA, Tukish OV, Rebrova TYu, Anikina DV, Mareev VYu. Difficulties in diagnosis of heart failure with preserved ejection fraction in clinical practice: Dissonance between echocardiography, NTproBNP and H2HFPEF score. Kardiologiya = Cardiology. 2019;59(S12):37–45 (In Russ.)).

EDN: QNZGFM. https://doi.org/10.18087/cardio.n695

28. Галявич А.С., Терещенко С.Н., Ускач Т.М., Агеев Ф.Т., Аронов Д.М., Арутюнов Г.П. с соавт. Хроническая сердечная недостаточность. Клинические рекомендации 2024. Российский кардиологический журнал. 2024;29(11):251–349. (Galyavich AS, Tereshchenko SN, Uskach TM, Ageev FT, Aronov DM, Arutyunov GP et al. Chronic heart failure. Clinical guidelines 2024. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2024;29(11):251–349 (In Russ.)).

EDN: WKIDLJ. https://doi.org/10.15829/1560-4071-2024-6162

29. Pieske B, Tschöpe C, de Boer RA, Fraser AG, Anker SD, Donal E et al. How to diagnose heart failure with preserved ejection fraction: The HFA-PEFF diagnostic algorithm: A consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Eur Heart J. 2019;40(40):3297–3317.

PMID: 31504452. https://doi.org/10.1093/eurheartj/ehz64

30. Sun Y, Si J, Li J, Dai M, King E, Zhang X et al. Predictive value of HFA-PEFF score in patients with heart failure with preserved ejection fraction. Front Cardiovasc Med. 2021;8:656536.

PMID: 34778384. PMCID: PMC8585787. https://doi.org/10.3389/fcvm.2021.656536

31. Кобалава Ж.Д., Сафарова А.Ф., Гудиева Х.М., Лукина О.И. Оценка риска развития неблагоприятных исходов у пациентов с клинически проявляющейся артериальной гипертензией и хронической сердечной недостаточностью с сохраненной фракцией выброса левого желудочка по алгоритму HFA-PEFF. Кардиология. 2023;63(2):3–10. (Kobalava ZhD, Safarova AF, Gudieva KhM, Lukina OI. Risk assessment of adverse outcomes in symptomatic patients with arterial hypertension and chronic heart failure with preserved ejection fraction using The HFA-PEFF Algorithm. Kardiologiya = Cardiology. 2023;63(2):3–10 (In Russ.)).

EDN: BFWKAY. https://doi.org/10.18087/cardio.2023.2.n2162

32. Braisch U, Koenig W, Rothenbacher D, Denkinger M, Friedrich N, Felix SB et al. N-terminal pro brain natriuretic peptide reference values in community-dwelling older adults. ESC Heart Fail. 2022;9(3):1703–12.

PMID: 35199488. PMCID: PMC9065825. https://doi.org/10.1002/ehf2.13834

33. Mueller C, McDonald K, de Boer RA, Maisel A, Cleland JGF, Kozhuharov N et al.; Heart Failure Association of the European Society of Cardiology. Heart Failure Association of the European Society of Cardiology practical guidance on the use of natriuretic peptide concentrations. Eur J Heart Failure. 2019;21(6):715–31.

PMID: 31222929. https://doi.org/10.1002/ejhf.1494

34. Dewan P, Jackson A, Lam CSP, Pfeffer MA, Zannad F, Pitt B, Solomon SD, McMurray JJV. Interactions between left ventricular ejection fraction, sex and effect of neurohumoral modulators in heart failure. Eur J Heart Fail. 2020;22(5):898–901.

PMID: 32115864. https://doi.org/10.1002/ejhf.1776

35. Rosch S, Kresoja K-P, Besler C, Fengler K, Schober AR, von Roeder M et al. Characteristics of heart failure with preserved ejection fraction across the range of left ventricular ejection fraction. Circulation. 2022;146(7):506–18.

PMID: 35862208. https://doi.org/10.1161/circulationaha.122.059280

36. Pieske B, Wachter R, Shah SJ, Baldridge A, Szeczoedy P, Ibram G et al.; PARALLAX Investigators and Committee members. Effect of sacubitril/valsartan vs standard medical therapies on plasma NT-proBNP concentration and submaximal exercise capacity in patients with heart failure and preserved ejection fraction: The PARALLAX randomized clinical trial. JAMA. 2021;326(19):1919–29.

PMID: 34783839. PMCID: PMC8596197. https://doi.org/10.1001/jama.2021.18463

37. Griffin M, Rao VS, Ivey-Miranda J, Fleming J, Mahoney D, Maulion C et al. Empagliflozin in heart failure: Diuretic and cardio-renal effects. Circulation. 2020;142(11):1028–39.

PMID: 32410463. PMCID: PMC7521417. https://doi.org/10.1161/circulationaha.120.045691

38. Butler J, Packer M, Filippatos G, Ferreira JP, Zeller C, Schnee J et al. Effect of empagliflozin in patients with heart failure across the spectrum of left ventricular ejection fraction. Eur Heart J. 2022;43(5):416–26.

PMID: 34878502. PMCID: PMC8825259. https://doi.org/10.1093/eurheartj/ehab798