Heart failure with reduced ejection fraction and diastolic dysfunction (HrEFwDD): Time for a new clinical entity

Heart failure with preserved ejection fraction (HFpEF) has moved from the stage of recognition of its existence to acceptance that it is a distinct clinical entity different from heart failure with reduced ejection fraction (HFrEF) or heart failure with mid-range reductions in LVEF (HFmEF). Fundamental to the acceptance of the entity of HFpEF was the data that its long term prognosis is poor and comparable to that of HFrEF [1]. This has led to the conclusion that the processes leading to impaired diastolic function which underlie HFpEF adversely affect outcome.