Aim: Present heart failure (HF) patients hospitalized during the period of one year in University Hospital Centre Rijeka, describe their characteristics and hospital outcome according to left ventricular ejection fraction (EF) with emphasis placed on heart failure with mid-range ejection fraction (HFmrEF) and compare our results with literature data (1).

Patients and Methods: Retrospective, observational study was conducted with a total of 375 subjects. All patients hospitalized for heart failure were included, same sample we introduced to European Society of Cardiology HF Register, except those presented with cardiogenic shock or acute coronary syndrome. Patients were classified in three groups according to their left ventricular ejection fraction (EF ≤40%, EF 40-49%, EF ≥50%) measured using echocardiography.

Results: In comparison with HFpEF (heart failure with preserved ejection fraction) subjects, patients with HFrEF (heart failure with reduced ejection fraction) were younger (73 vs. 78 years, p<0.01), more commonly male (64% vs 34%, p<0.01) with left bundle branch block (32% vs. 7%, p<0.01) and higher prevalence of ischemic HF etiology (52% vs. 22%, p<0.01). HRpEF patients had hypertension (3% vs 14%) more often as a confirmed cause of HF. As expected, atrial fibrillation was significantly more common in HFpEF group (41% vs. 65%, p<0.01). The HFmrEF category resembled the HFpEF population regarding age, gender, body mass index and atrial fibrillation frequency. The average length of hospitalization (8 days) and the intrahospital mortality (6%) did not differ significantly between groups.

Conclusion: Despite possible differences between HFmrEF and the other two investigated HF categories, our HFmrEF population predominantly resembled HFpEF group. Unlike HFrEF group characteristics and its management, the other two heart failure categories are globally not sufficiently defined. Hence their future research is of special importance for development of evidence-based medical practice.