Heart Failure Beat: HFmrEF: Finding a Compass in the Heart Failure "No Man's Land"

Heart failure with mildly reduced ejection fraction (HFmrEF) affects up to 25% of patients with heart failure, yet many clinicians remain uncertain about how best to diagnose and treat it. In this episode, HFSA Scientific Statement co-authors Jane E. Wilcox, MD, and Barry A. Borlaug, MD, discuss the evidence, clinical implications, and key takeaways from the newly published HFSA Scientific Statement.

Heart failure with mildly reduced ejection fraction (HFmrEF) affects up to one in four patients with heart failure, yet it remains one of the most misunderstood and under-discussed phenotypes in clinical practice. In this episode of Heart Failure Beat, hosts Michael Beasley, MD, and Priya Umapathi, MD, sit down with Jane E. Wilcox, MD, and Barry A. Borlaug, MD, co-lead authors of the newly published HFSA Scientific Statement: Heart Failure with Mildly Reduced Ejection Fraction, to discuss why this patient population deserves greater attention.

The conversation explores how HFmrEF fits between HFrEF and HFpEF, why ejection fraction alone may not tell the whole story, practical treatment considerations, and the important concept of HFmrEF as both an overlap and transitional state.

Read the Scientific Statement: HFSA Scientific Statement: Heart Failure with Mildly Reduced Ejection Fraction

Published in the June 2026 issue of the Journal of Cardiac Failure.

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Episode Editors

Craig Beavers, PharmD, FACC, FAHA, FCCP, BCCP, BCPS-AQ Cardiology, CACP

Ramya Sampath, MD

Carol R. Wade RN, DNP, CRNP

Hosts

Michael H. Beasley, MD

HF Beat Co-Host

Priya Umapathi, MD

HF Beat Co-Host

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References, Links and Disclosures

Barry A. Borlaug, MD: Research Support:
NIH/NHLBI, US Dept of Defense, Axon, AstraZeneca, Corvia, Medtronic, Tenax Therapeutics

Consulting/Advisory Board:
Actelion, Amgen, Aria, Boehringer Ingelheim, Edwards, Eli Lilly, Imbria, Janssen, Merck, Novo Nordisk, VADovations

Jane Wilcox, MD, MSc, FHFSA: Consultant/Advisory Board/DSMB/CEC: Abbott, Cytokinetics, IONIS, FIRE1, Johnson and Johnson Med Tech

June (2026) issue of the Journal of Cardiac Failure

Disclaimer

The opinions and perspectives expressed in this episode are those of the individual guests and hosts and do not necessarily reflect the official views of the Heart Failure Society of America (HFSA). This discussion is intended for educational purposes only and does not constitute medical advice or an endorsement of any specific pharmaceutical product or therapy. HFSA does not endorse one medication over another. Patients should consult their healthcare professionals for individualized evaluation and treatment decisions.