{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:02:24Z","timestamp":1788134544326,"version":"build-2803163510"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2017,3,15]],"date-time":"2017-03-15T00:00:00Z","timestamp":1489536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Horten Research Foundation"},{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Menarini"},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011725","name":"Servier","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004337","name":"Roche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004337","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004334","name":"Merck","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>While the conditions of heart failure (HF) with reduced (HFrEF, LVEF &amp;lt; 40%) and preserved (HFpEF, LVEF \u2265 50%) left ventricular ejection fraction (LVEF) are well characterized, it is unknown whether patients with HF and mid-range LVEF (HFmrEF, LVEF 40\u201349%) have to be regarded as a separate clinical entity. The aim of this study was to characterize these three populations and to compare outcome and response to therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>The analysis was based on the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF) comprising a population with established HF including the whole spectrum of LVEF. Of the 622 patients, 108 (17%) were classified as having HFmrEF. This group was in general found to be \u2018intermediate\u2019 regarding clinical characteristics with a comparable and high burden of comorbidities and equally impaired quality of life but was more likely to have coronary artery disease as compared with the HFpEF group. During a median follow-up of 794 days, mortality was 39.7% without significant differences between groups. N-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided as compared with standard therapy resulted in improved survival free of HF hospitalizations in HFrEF and HFmrEF, but not in HFpEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although the \u2018intermediate\u2019 clinical profile of HFmrEF between HFrEF and HFpEF would support the conclusion that HFmrEF is a distinct clinical entity, we hypothesize that HFmrEF has to be categorized as HFrEF because of the high prevalence of coronary artery disease and the similar benefit of NT-proBNP-guided therapy in HFrEF and HFmrEF, in contrast to HFpEF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.798","type":"journal-article","created":{"date-parts":[[2017,3,15]],"date-time":"2017-03-15T01:46:38Z","timestamp":1489542398000},"page":"1586-1596","source":"Crossref","is-referenced-by-count":128,"title":["Heart Failure With Mid-Range Ejection Fraction: A Distinct Clinical Entity? Insights From The Trial of Intensified Versus Standard Medical Therapy in Elderly Patients With Congestive Heart Failure (TIME-CHF)"],"prefix":"10.1093","volume":"19","author":[{"given":"Peter","family":"Rickenbacher","sequence":"first","affiliation":[{"name":"Division of Cardiology, University Hospital Basel \u00a0","place":["Switzerland"]},{"name":"Division of Cardiology, Internal Medicine University Department , Kantonsspital Baselland, Bruderholz ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beat A.","family":"Kaufmann","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University Hospital Basel \u00a0","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha T.","family":"Maeder","sequence":"additional","affiliation":[{"name":"Cardiology Division, Kantonsspital St Gallen , St Gallen ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Bernheim","sequence":"additional","affiliation":[{"name":"Cardiology Division, Triemli Hospital , Z\u00fcrich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaatje","family":"Goetschalckx","sequence":"additional","affiliation":[{"name":"Cardiology Division, University Hospital , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otmar","family":"Pfister","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University Hospital Basel \u00a0","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Pfisterer","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University Hospital Basel 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