在射血分数降低型心力衰竭（heart failure with reduced ejection fraction，HFrEF）患者中，部分患者的左室射血分数（left ventricular ejection fraction，LVEF）经治疗后在后续评估中出现明显改善。2022年美国心脏学会/美国心脏病协会/美国心衰学会（American Heart Association/American College of Cardiology/Heart Failure Society of America，AHA/ACC/HFSA）颁布的心力衰竭管理指南将既往LVEF≤40%且在随访过程中提升至40%以上的心力衰竭类型命名为射血分数改善型心力衰竭（heart failure with improved ejection fraction，HFimpEF）。研究表明，HFimpEF患者的全因死亡率、心力衰竭再住院率较低，预后明显优于HFrEF，可作为HFrEF患者的阶段性治疗目标。关于HFimpEF患者的热点讨论主要围绕2个方面，即HFimpEF的目标人群特征及LVEF提升的有效手段、HFimpEF患者心功能维持治疗方案；尤其是后者，尚无明确的临床指南推荐。因此，回顾现有研究，系统总结促使HFrEF向HFimpEF转归的治疗方案，以及有效针对HFimpEF的维持手段至关重要。该文对现有药物、器械、手术治疗的LVEF改善效果及HFimpEF患者的监测与治疗方法进行综述。对于HFrEF患者，现有临床研究提示β受体阻滞剂及心脏再同步治疗等能够显著改善LVEF并提升至40%以上；对于HFimpEF患者，钠-葡萄糖转运体2抑制剂及肾素-血管紧张素系统抑制剂能够有效维持患者LVEF及其心脏功能。此外，该文也提出HFimpEF现有研究的不足与未来的研究方向。

In patients with heart failure with reduced ejection fraction (HFrEF), some individuals demonstrate significant improvement in left ventricular ejection fraction (LVEF) during subsequent evaluations after treatment. The 2022 American Heart Association/American College of Cardiology/Heart Failure Society of America (AHA/ACC/HFSA) heart failure management guidelines introduced the term "heart failure with improved ejection fraction (HFimpEF)" to describe patients with prior LVEF≤40% that subsequently increased above 40% during follow-up. Studies indicate that HFimpEF patients exhibit lower all-cause mortalities and heart failure rehospitalization rates, with a significantly better prognosis compared to HFrEF patients, establishing HFimpEF as a staged therapeutic target for HFrEF. Current discussion on HFimpEF primarily focuses on two aspects: characteristics of the target population and effective methods for LVEF improvement, and maintenance strategies for cardiac function preservation in HFimpEF patients; particularly the latter lacks clear clinical-guideline recommendations. Therefore, reviewing existing research to systematically summarize therapeutic strategies that promote the HFrEF-to-HFimpEF transition and effective maintenance approaches for HFimpEF becomes crucial. This article comprehensively reviews the LVEF-improving effects of current pharmacological, device-based, and surgical interventions, along with monitoring and management strategies for HFimpEF patients. In HFrEF patients, clinical evidence suggests that β-blockers and cardiac resynchronization therapy can significantly improve LVEF beyond 40%. Regarding HFimpEF management, sodium-glucose cotransporter-2 inhibitors (SGLT2i) and renin-angiotensin system inhibitors (RASi) demonstrate efficacy in maintaining LVEF and cardiac function. Additionally, this review identifies current research limitations in HFimpEF and proposes potential future research directions.