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population distribution (upper or lower 5% or 1%) to determine “normal.” A recent meta-analysis of such population studies that included adults without clini-cal cardiovascular or renal disease, hypertension, or diabetes found that the threshold for a normal LVEF (defined as the lower 5th percentile of the distribu-
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The current ACCF/AHA guidelines classify patients with a left ventricular ejection fraction (LVEF) of ≥50% as having a preserved ejection fraction (4), and previous studies have found that asymptomatic patients with lower LVEF are at greater risk of developing HF.
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