Heterogeneous Outcomes of Heart Failure with Better Ejection Fraction.

Pubmed ID: 31721131

Pubmed Central ID: PMC7170767

Journal: Journal of cardiovascular translational research

Publication Date: April 1, 2020

Affiliation: Regeneration Next, Duke University, Durham, NC, USA. ravi.karra@duke.edu.

Link: https://link.springer.com/content/pdf/10.1007%2Fs12265-019-09919-9.pdf?link_time=2024-04-24_03:45:47.018247

MeSH Terms: Humans, Male, Female, Aged, Multicenter Studies as Topic, Risk Factors, Middle Aged, Randomized Controlled Trials as Topic, Heart Failure, Hospitalization, Disease Progression, Cause of Death, Stroke Volume, Time Factors, Ventricular Function, Left, Databases, Factual, Health Status, Recovery of Function, Progression-Free Survival

Grants: K08 HL116485, T32 HL007101

Authors: Fudim M, Green CL, Van Kirk J, Karra R

Cite As: Van Kirk J, Fudim M, Green CL, Karra R. Heterogeneous Outcomes of Heart Failure with Better Ejection Fraction. J Cardiovasc Transl Res 2020 Apr;13(2):142-150. Epub 2019 Nov 13.

Studies:

Abstract

We evaluated the heterogeneity of outcomes among heart failure patients with ventricular recovery. The BEST trial studied patients with left ventricular ejection fraction (LVEF) ≤ 35%. Serial LVEF assessment was performed at baseline, 3 months, and 12 months. Heart failure with better ejection fraction (HFbEF) was defined as an LVEF > 40% at any point. Of the patients who survived to 1 year, 399 (21.3%) had HFbEF. Among subjects with HFbEF, 173 (43.4%) had "extended" recovery, 161 (40.4%) had "late" recovery, and 65 (16.3%) patients had "transient" recovery. Subjects with HFbEF had an improved event-free survival from death or first HF hospitalization compared to subjects without recovery (HR 0.50, 95% CI, 0.39-0.64, p < 0.001). Compared to "transient" recovery, "late" and "extended" recovery were associated with an improved event-free survival from all-cause death and HF hospitalization (HR 0.55, 95% CI, 0.34-0.90, p = 0.016). Our study shows patients with HFbEF to be a heterogeneous population with differing prognoses.