open access

Vol 25, No 3 (2018)
Original articles — Clinical cardiology
Published online: 2017-09-06
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Heart failure with recovered ejection fraction: Clinical characteristics, determinants and prognosis. CARDIOCHUS-CHOP registry

Rosa Agra Bermejo, Eva Gonzalez Babarro, J. Nicolás López Canoa, Alfonso Varela Román, Inés Gómez Otero, Marcos Oro Ayude, Pablo Parada Vazquez, Isabel Gómez Rodríguez, Oscar Díaz Castro, Jose Ramón González Juanatey
DOI: 10.5603/CJ.a2017.0103
·
Pubmed: 28980289
·
Cardiol J 2018;25(3):353-362.

open access

Vol 25, No 3 (2018)
Original articles — Clinical cardiology
Published online: 2017-09-06

Abstract

Background: The magnitude and the prognostic impact of recovering left ventricular ejection fraction (LVEF) in patients with heart failure (HF) and systolic dysfunction is unclear. The aim of this study was to evaluate the clinical characteristics and prognosis of patients with HFrecEF in an HF population.

Methods: 449 consecutive patients were selected with the diagnosis of HF and an evaluation of LVEF in the 6 months prior to selection who were referred to two HF units. Patients with systolic dysfunction were only considered if a second echocardiogram was performed during the follow-up.

Results: At the time of diagnosis, 207 patients had LVEF > 40% (HFpEF) and 242 had LVEF ≤ 40% (HFrEF). After 1 year, the LVEF was re-evaluated in all 242 patients with a LVEF ≤ 40%: in 126 (52%), the second LVEF was > 40% (HFrecEF), and the remaining 116 (48%) had LVEF ≤ 40% (HFrEF). After 1800 ± 900 days of follow-up patients with recovered LVEF had a significantly lower mortality rate (HFpEF vs. HFrecEF: hazard ratio [HR] = 2.286, 95% confidence interval [95% CI] 1.264–4.145, p = 0.019; HFrEF vs. HFrecEF: HR = 2.222, 95% CI 1.189–4.186, p < 0.001) and hospitalization rate (HFpEF vs. HFrecEF: HR = 1.411, 95% CI 1.046–1.903, p = 0.024; HFrEF vs. HFrecEF: HR = 1.388, 95% CI 1.002–1.924, p = 0.049). The following are predictors of LVEF recovery: younger age, lower functional class, treatment with renin–angiotensin–aldosterone system inhibitors and beta-blockers, absence of defibrillator use, and non-ischemic etiology.

Conclusions: Patients with HF and reduced LVEF who were re-evaluated after 1 year, had significant improvement in their LVEF and had a more favourable prognosis than HF with preserved and reduced ejection fraction.

Abstract

Background: The magnitude and the prognostic impact of recovering left ventricular ejection fraction (LVEF) in patients with heart failure (HF) and systolic dysfunction is unclear. The aim of this study was to evaluate the clinical characteristics and prognosis of patients with HFrecEF in an HF population.

Methods: 449 consecutive patients were selected with the diagnosis of HF and an evaluation of LVEF in the 6 months prior to selection who were referred to two HF units. Patients with systolic dysfunction were only considered if a second echocardiogram was performed during the follow-up.

Results: At the time of diagnosis, 207 patients had LVEF > 40% (HFpEF) and 242 had LVEF ≤ 40% (HFrEF). After 1 year, the LVEF was re-evaluated in all 242 patients with a LVEF ≤ 40%: in 126 (52%), the second LVEF was > 40% (HFrecEF), and the remaining 116 (48%) had LVEF ≤ 40% (HFrEF). After 1800 ± 900 days of follow-up patients with recovered LVEF had a significantly lower mortality rate (HFpEF vs. HFrecEF: hazard ratio [HR] = 2.286, 95% confidence interval [95% CI] 1.264–4.145, p = 0.019; HFrEF vs. HFrecEF: HR = 2.222, 95% CI 1.189–4.186, p < 0.001) and hospitalization rate (HFpEF vs. HFrecEF: HR = 1.411, 95% CI 1.046–1.903, p = 0.024; HFrEF vs. HFrecEF: HR = 1.388, 95% CI 1.002–1.924, p = 0.049). The following are predictors of LVEF recovery: younger age, lower functional class, treatment with renin–angiotensin–aldosterone system inhibitors and beta-blockers, absence of defibrillator use, and non-ischemic etiology.

Conclusions: Patients with HF and reduced LVEF who were re-evaluated after 1 year, had significant improvement in their LVEF and had a more favourable prognosis than HF with preserved and reduced ejection fraction.

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Keywords

heart failure, recovered, left ventricular ejection fraction

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About this article
Title

Heart failure with recovered ejection fraction: Clinical characteristics, determinants and prognosis. CARDIOCHUS-CHOP registry

Journal

Cardiology Journal

Issue

Vol 25, No 3 (2018)

Pages

353-362

Published online

2017-09-06

DOI

10.5603/CJ.a2017.0103

Pubmed

28980289

Bibliographic record

Cardiol J 2018;25(3):353-362.

Keywords

heart failure
recovered
left ventricular ejection fraction

Authors

Rosa Agra Bermejo
Eva Gonzalez Babarro
J. Nicolás López Canoa
Alfonso Varela Román
Inés Gómez Otero
Marcos Oro Ayude
Pablo Parada Vazquez
Isabel Gómez Rodríguez
Oscar Díaz Castro
Jose Ramón González Juanatey

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