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Study breakdown

Comprehensive Review of Heart Failure with Reduced Ejection Fraction

evidence
The takeaway

Heart failure with reduced ejection fraction affects tens of millions globally, diagnosed via natriuretic peptides and cardiac imaging, with evolving treatment approaches.

70 million affected globally

HFrEF has 2% prevalence in Europe/North America, diagnosed via BNP and cardiac imaging

What the researchers found

HFrEF accounts for approximately half of all heart failure cases, with diagnosis relying on natriuretic peptide levels, cardiac imaging, and clinical signs/symptoms.

Why it matters

HFrEF affects 70 million people globally and is a leading cause of hospitalization, disability, and death. Evidence-based treatment can significantly improve outcomes.

How the study worked

Comprehensive clinical review of heart failure with reduced ejection fraction epidemiology, diagnosis, and management.

What this study cannot tell us

Review article — provides overview rather than new data. Treatment recommendations may evolve as new evidence emerges.

How to read the evidence

Authoritative clinical review — synthesizes established evidence and guidelines.

When this study was published

Published in 2026; reflects current diagnostic and treatment standards.

The bigger picture

Advances in HFrEF treatment — including neurohormonal blockers, devices, and now GLP-1 drugs — have transformed survival, but the condition remains a major global health burden.

Questions still open

  • How will GLP-1 drugs and other new therapies change HFrEF management?
  • Can early detection via natriuretic peptide screening reduce HFrEF burden?

Common questions

What is heart failure with reduced ejection fraction?
HFrEF occurs when the heart muscle weakens and can't pump blood effectively. The "ejection fraction" measures how much blood the heart pumps out with each beat — in HFrEF, this is reduced below 40%.
How is HFrEF diagnosed?
Doctors use blood tests for natriuretic peptides (BNP or NT-proBNP), heart imaging (echocardiography), and clinical signs like shortness of breath and fluid retention to diagnose HFrEF.

Read the original research

Heart failure with reduced ejection fraction.

Lancet (London, England), 407(10527), 529-542

Citation

Cannata, Antonio; Crespo-Leiro, Maria Generosa; Bromage, Daniel I; Ruschitzka, Frank; McDonagh, Theresa A. (2026). Heart failure with reduced ejection fraction.. Lancet (London, England), 407(10527), 529-542. https://doi.org/10.1016/S0140-6736(25)01851-3