Javaloyes P, Marquina V, Llorens P

Language: Spanish
References: 13
Page: 185-186
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To the Editor:

We would like to thank Martín-Sánchez et al for their comments on our heart failure (HF) with midrange ejection fraction (HFmrEF) review, and we would like to clarify some of the aspects reported.
They relate that HFmrEF, more than a transitional state, seems to be the presence of two concurrent nosological processes, and exemplify the existence of ischemic heart disease in a senile heart. Although we still lack quite a bit of knowledge about patients with HFmrEF and, above all, their physiopathology, characteristics and therapeutics, current evidence upholds that it is a category in itself between reduced (HFrEF) and preserved (HFpEF) ejection fraction. Several studies still consider that it is a different clinical entity and not a “new transient phenomenon” 4,5, with a different prognosis, and evidence that a high number of patients (between 30 and 70%) make a transition towards HFpEF or HFrEF.

REFERENCES

1. Martín-Sánchez FJ, Angós B, Bajo Cardassay E, Rodríguez Adrada E. Insuficiencia cardíaca con fracción de eyección intermedia: ¿Dos entidades superpuestas? CorSalud. 2019;11(2):184-5. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/377 [ Links ]

2. Javaloyes P, Marquina V, Llorens P. Insuficiencia cardíaca con fracción de eyección intermedia: ¿Nueva entidad? CorSalud [Internet]. 2018 [citado 27 Dic 2019];10(3):242-9. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/358/732 [ Links ]

3. Yamamoto M, Seo Y, Ishizu T, Nishi I, Hamada-Harimura Y, Machino-Ohtsuka T, et al. Different impact of changes in left ventricular ejection fraction between heart failure classifications in patients with acute decompensated heart failure. Circ J. 2019;83(3):584-94. [ Links ]

4. Webb J, Draper J, Fovargue L, Sieniewicz B, Gould J, Claridge S, et al. Is heart failure with mid range ejection fraction (HFmrEF) a distinct clinical entity or an overlap group? Int J Cardiol Heart Vasc. 2018;21:1-6. [ Links ]

5. Lund LH. Heart failure with mid-range ejection fraction: lessons from CHARM. Card Fail Rev. 2018;4(2):70-2. [ Links ]

6. Lam CS, Solomon SD. Fussing over the middle child: heart failure with mid-range ejection fraction. Circulation. 2017;135(14):1279-80. [ Links ]

7. Formiga F, Chivite D. Insuficiencia cardiaca aguda: básico conocer al paciente. Emergencias. 2018;30(3):145-6. [ Links ]

8. Masip J. ¿Es efectivo MEESSI para dar el alta desde urgencias a los pacientes con insuficiencia cardiaca aguda? Emergencias. 2019;31(1):3-4. [ Links ]

9. Streng KW, Nauta JF, Hillege HL, Anker SD, Cleland JG, Dickstein K, et al. Non-cardiac comorbidities in heart failure with reduced, mid-range and preserved ejection fraction. Int J Cardiol. 2018;271:132-9. [ Links ]

10. Momomura SI, Ito M. Heart failure mid-range ejection fraction - heart failure with multiple personalities. Circ J. 2019;83(2):274-6. [ Links ]

11. Miró O, Gil V, Rosselló X, Martín-Sánchez FJ, Llorens P, Jacob J, et al. Eventos adversos en pacientes con insuficiencia cardiaca aguda clasificados de bajo riesgo por la escala MEESSI y dados de alta desde urgencias: cuantificación y predictibilidad. Emergencias. 2019;31(1):5-14. [ Links ]

12. Martín-Sánchez FJ, Rodríguez-Adrada E, Vidan MT, Díez Villanueva P, Llopis García G, González Del Castillo J, et al. Impacto de las variables geriátricas en la mortalidad a 30 días de los ancianos atendidos por insuficiencia cardiaca aguda. Emergencias. 2018;30(3):149-55. [ Links ]

13. Llorens P. Necesidad de evaluar el riesgo de los pacientes con insuficiencia cardiaca aguda en los servicios de urgencias más allá del juicio clínico. Emergencias. 2018;30(2):75-6. [ Links ]