Death and Dying in Heart Failure With Normal Ejection Fraction

The overall mortality rate in patients with heart failure with normal ejection fraction (HFNEF) appears to be comparable to that in patients with heart failure with reduced ejection fraction. In contrast to the latter group of patients, randomized trials with neurohumoral blockade in patients with HFNEF have failed to demonstrate reduction in mortality. This is at least in part related to the lower proportion of heart failure–related death in the overall population of patients with HFNEF. In conclusion, better characterization of patients with HFNEF at greatest risk for heart failure–related death and understanding the risks of the different modes of death would allow more effective use of specific heart failure medical or device therapy in patients with HFNEF.