Back to Glossary
Heart Failure with Reduced Ejection Fraction
Heart failure with LVEF ≤40%. The classical systolic heart-failure phenotype, with established disease-modifying therapy.
HFrEF is heart failure with a reduced ejection fraction (LVEF ≤40%). The hallmark is impaired systolic contractility, typically from ischaemic heart disease, dilated cardiomyopathy, or post-viral myocarditis.
HFrEF has the most extensive evidence-based pharmacologic toolkit: ACE inhibitors / ARBs / ARNIs, beta-blockers, mineralocorticoid-receptor antagonists, and SGLT2 inhibitors form the "four pillars" of guideline-directed medical therapy.
Eligibility for device therapy (ICD for primary prevention; CRT in QRS-widened patients) is also LVEF-driven, making accurate, reproducible LVEF measurement clinically decisive.