Left ventricular structure and function in chronic heart failure

	Heart failure with reduced ejection fraction (HFrEF)	Heart failure with preserved ejection fraction (HFpEF)
LV remodeling
End-diastolic volume	↑ (May be normal in acute heart failure)	Normal
End-systolic volume	↑	Normal
Mass	↑ (May be normal in acute heart failure)	Normal or ↑
Geometry	Eccentric	Normal or Concentric
LV systolic properties
Performance
Stroke volume	↓ (or normal)	Normal (or ↓)*
Function
Longitudinal strain	↓	↓
Ejection fraction	↓ (≤40 percent)	Normal or near normal (≥50)
Contractility
End-systolic elastance	↓	Normal (or ↑)
Stress shortening	↓	↓
Preload reserve	Exhausted	Limited
LV diastolic properties
End-diastolic pressure	↑	↑
Tau	↑	↑
Chamber stiffness	↓	↑
Myocardial stiffness	Normal (or ↑)	↑

* In patients with heart failure with preserved ejection fraction, stroke volume is often impaired with exercise.

Original table provided courtesy of Dr. Michael Zile and modified by Dr. Barry Borlaug.

Graphic 55386 Version 8.0