Heart Failure: A Growing Public Health Crisis

Heart failure (HF) is a critical and escalating health challenge, responsible for 1 in every 10 deaths in the United States and ranking among the leading causes of mortality in the developed world. An estimated 7 million Americans currently live with heart failure, and each year, more than 550,000 new cases are diagnosed. Among individuals over the age of 65, heart failure is the number one cause of hospitalization [1].

While heart failure has a wide range of causes [2], it is broadly classified into two types:

• HFrEF (Heart Failure with reduced Ejection Fraction) – where the heart muscle cannot contract effectively

• HFpEF (Heart Failure with preserved Ejection Fraction) – where the heart muscle becomes stiff and cannot relax properly

Both forms involve dysfunction of the left ventricle (LV)—the heart’s main pumping chamber. In HFrEF, the LV dilates and weakens; in HFpEF, it thickens and loses flexibility. In both cases, the heart fails to deliver sufficient oxygenated blood to the body while causing fluid buildup in the lungs, leading to breathlessness, fatigue, and a cascade of worsening health events.

Although the terminology around ejection fraction (EF) can be confusing, the core issue is straightforward: less blood is being pumped out with each beat, creating a dual burden—blood congestion in the lungs and inadequate perfusion to vital organs. Over time, this imbalance drives disease progression and, ultimately, patient mortality.

• EF = (stroke volume)/(end-diastolic volume)