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Improvement of cardiac function persists long term with medical therapy for left ventricular systolic dysfunction

David Chen1, Richard Chang, Branavan Umakanthan

  • 1Department of Cardiology, Loma Linda University Medical Center, Loma Linda, California, USA.

Journal of Cardiovascular Pharmacology and Therapeutics
|September 19, 2007
PubMed

Insights

Medical therapy can improve left ventricular (LV) systolic dysfunction. Initial improvements in LV ejection fraction are often sustained long-term, particularly in younger patients with nonischemic heart disease.

Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Left ventricular (LV) systolic dysfunction can improve with medical therapy.
  • Long-term stability of cardiac function after treatment is not well understood.

Purpose of the Study:

  • To assess the long-term stability of left ventricular (LV) function in patients with systolic dysfunction after medical therapy.
  • To identify predictors of sustained improvement in LV ejection fraction.

Main Methods:

  • Retrospective analysis of 171 patients with baseline LV ejection fraction ≤45%.
  • Echocardiograms at baseline, 2-12 months, and final follow-up.
  • Analysis of clinical factors predicting LV ejection fraction improvement.

Main Results:

  • 48.5% of patients showed initial improvement in LV function.
  • Sustained improvement was observed in 88% of these patients at ~44 months.
  • Nonischemic etiology and younger age predicted significant LV ejection fraction improvement.

Conclusions:

  • Medical therapy can lead to sustained improvements in LV function in select patients.
  • Early and sustained improvements in LV ejection fraction may correlate with better long-term survival.
  • Younger patients with nonischemic cardiomyopathy are more likely to experience functional recovery.

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