Heart Failure Better EF: A Modern Diagnosis

Abstract

Improving Outcomes for Patients Referred With Heart Failure

The emerging population of heart failure with improved ejection fraction, characterized in this issue of Circulation by Basuray et al¹ for three heart failure centers, testifies to the cumulative benefit of therapeutic advances during the past 30 years. The initial triage for referral to heart failure centers, many of which were launched with the approval of cyclosporine in 1984, was an assumed "less than six months to live", derived from the classic Stanford experience in which most waiting transplant candidates who did not receive transplantation were dead within 6 months². Although the prognosis was not uniformly grim, most patients referred to transplant centers were dead within 1-2 years on the limited medical therapy of that time.