# Heart failure with mildly reduced or preserved ejection fraction

Condition · id `cardio:hfpef` · Cardiovascular Atlas · release `f6f6f1b6f50379ed` (public)

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Also called: HFpEF; HFmrEF/HFpEF; Heart failure with preserved ejection fraction

Browse, organ or system: Heart  
Browse, condition area: Heart failure  

## In plain language

Heart failure in which the left side of the heart pumps out a larger share of its blood but is too stiff to relax and fill properly. A US government patient page names high blood pressure, along with other conditions that add to the heart's workload, as the main causes of the preserved type, and says obesity and diabetes can also stiffen the heart. Two trials in this atlas, EMPEROR-Preserved and DELIVER, tested SGLT2 inhibitors in people with an ejection fraction above 40%, which covers the mildly reduced range as well as the preserved range.

## Technical summary

This record covers the band above the HFrEF cut-off. A US government diagnosis page calls an ejection fraction of 50% or more preserved and 41% to 49% borderline, while EMPEROR-Preserved and DELIVER enrolled people with an ejection fraction above 40%, so the trials span both. FINEARTS-HF enrolled people with an ejection fraction of 40% or greater, so it also includes the 40% value that the same page counts in the reduced range. A US government treatment page, dated 2022-03-24, says the main treatments for the preserved type were diuretics and that blood pressure medicines may also be prescribed, and it describes SGLT2 inhibitor use in heart failure as still being studied. The MeSH heading Heart Failure, Diastolic (D054144) is a broad match.

## Connected pages

- Heart failure with mildly reduced or preserved ejection fraction is a type of heart failure: Heart failure (`cardio:heart-failure`)
- Files under this front: Medicines (`cardio:front-medicines`)
- Related to: Left ventricular ejection fraction (LVEF) (`cardio:lvef`)
- Treated by: Dapagliflozin (`cardio:dapagliflozin`) [a claim, not a settled fact; see claim `cardio:claim-deliver-primary-effect` and its context]
- Treated by: Empagliflozin (`cardio:empagliflozin`) [a claim, not a settled fact; see claim `cardio:claim-emperor-preserved-primary-effect` and its context]
- Evaluated for this: Finerenone (`cardio:finerenone`) [a claim, not a settled fact; see claim `cardio:claim-finearts-hf-primary-effect` and its context]
- Investigated in: DELIVER (`cardio:deliver`)
- Investigated in: EMPEROR-Preserved (`cardio:emperor-preserved`)

## Provenance

Content hash: 20a19c478c234e73ddd06d2463db7a9a70b53b09008b566eb8f0a31009b02564
Last substantive edit: 2026-10-15
Evidence last checked: 2026-10-14