Heart failure with reduced ejection fraction

Heart failure with left ventricular ejection fraction commonly defined as 40% or less. It reflects impaired ventricular pumping and is treated with therapies that reduce symptoms and improve outcomes.

Left ventricular systolic dysfunction: Impaired contraction of the left ventricle that reduces the amount of blood ejected with each heartbeat. The defining pumping impairment underlying reduced ejection fraction.
Angiotensin-converting enzyme inhibitor: A drug that inhibits formation of angiotensin II, lowering vascular resistance and aldosterone signaling. ACE inhibitors reduce harmful neurohormonal effects and improve outcomes in eligible patients.
Ejection fraction: The proportion of blood in a ventricle at end-diastole expelled with each contraction. The reduced value defines this heart-failure category, though it does not measure all cardiac function.
Ischemic cardiomyopathy: Ventricular dysfunction caused by coronary artery disease and myocardial ischemic injury. Coronary disease and prior infarction are frequent causes of reduced pumping function.
Frank–Starling law: The principle that greater cardiac muscle stretch increases contraction force within physiological limits. Early increases in filling can temporarily preserve output despite reduced contractility.
Beta blocker: A medication that blocks beta-adrenergic receptors and reduces effects of sympathetic stimulation. Evidence-based beta blockers reduce mortality and hospitalization in stable disease.
Echocardiography: Ultrasound imaging that evaluates cardiac structure, motion, blood flow, and ventricular function. It commonly measures ejection fraction and identifies structural causes of heart failure.
Dilated cardiomyopathy: A disorder marked by ventricular dilation and impaired systolic contraction not explained by abnormal loading conditions alone. It is a common structural pattern associated with reduced ejection fraction.
Renin–angiotensin–aldosterone system: A hormonal system that regulates blood pressure, fluid balance, and vascular tone. Its activation promotes fluid retention and remodeling that worsen chronic heart failure.
Mineralocorticoid receptor antagonist: A drug that blocks aldosterone’s mineralocorticoid receptor, reducing sodium retention and tissue fibrosis. This treatment adds survival benefit for appropriate patients despite optimized foundational therapy.

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