Letters Heart failure in need of a diagnosis

Ontological fallacy in heart failure

BMJ 2009; 338 doi: http://dx.doi.org/10.1136/bmj.b1304 (Published 31 March 2009) Cite this as: BMJ 2009;338:b1304
  1. Hugh F McIntyre, consultant physician
  1. 1East Sussex NHS Trust, Conquest Hospital, Hastings TN37 7RD
  1. Hugh.mcintyre{at}esht.nhs.uk

    Echocardiography1 has resulted in the belief that heart failure and reduced ejection fraction are synonymous. Recently, however, the utility of ejection fraction in diagnosis has been undermined by epidemiological studies, which have shown that ejection fraction is continuously distributed in populations with heart failure,2 and that survival is the same irrespective of whether there is heart failure with normal ejection fraction (HFNEF) or with …

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