ABC | Volume 112, Nº6, June 2019

Review Article Mesquita et al HFmrEF - state of the art Arq Bras Cardiol. 2019; 112(6):784-790 1. Wang TJ, Evans JC, Benjamin EJ, LevyD, LeRoy EC, Vasan RS. Natural History of Asymptomatic Left Ventricular Systolic Dysfunction in the Community. Circulation. 2003;108(8):977–82. 2. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2013;62(16):e147–239. 3. Ponikowski P, Voors AA, Anker SD, BuenoH, Cleland JG, Coats AJ, et al. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016;37(27):2129–200. 4. 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References Future perspectives The precision medicine use in the cardiovascular area has advanced, and the identification of HF phenotypes is important for the development of new therapeutic alternatives that offer a better prognosis for the patient with HF. Although some studies have demonstrated the efficacy of certain therapies in patients with HFmrEF, most publications are retrospective studies that perform a new analysis of previous databases. Therefore, prospective studies and randomized clinical trials including patients with HFmrEF are essential for the creation of therapies with solid evidence‑based recommendations. Conclusion After the establishment of HFmrEF as a new HF category by national and international guidelines, there was a considerable increase in publications on this type of patients, which allowed a better understanding of their clinical profile, pathophysiological and clinical outcome. However, there is still a great shortage of prospective studies and randomized double-blind clinical trials that allow the specific therapy delineation for this new category of HF. The knowledge of HFmrEF peculiarities by cardiologists and internists is fundamental for the best diagnosis and management of these patients, in addition to the identification of areas of uncertainty regarding the development of basic and clinical researches. Author contributions Conception and design of the research, Analysis and interpretation of the data, Writing of the manuscript and Critical revision of the manuscript for intellectual content: Mesquita ET, Barbetta LMS, Correia ETO; Acquisition of data: Barbetta LMS, Correia ETO. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This study is not associatedwith any thesis or dissertationwork. Ethics approval and consent to participate This article does not contain any studies with human participants or animals performed by any of the authors. 789