Heart failure with recovered ejection fraction: a distinct clinical entity.

Area of Science:

• Cardiology
• Heart Failure Research

Background:

• A subset of heart failure (HF) patients with preserved ejection fraction (EF) previously had EF <40%.
• These "recovered" EF patients may be prevalent and distinct within HF referral populations.

Purpose of the Study:

• To determine the prevalence and clinical characteristics of recovered ejection fraction (HF-REF) patients.
• To compare HF-REF patients with those having persistently preserved (HF-PEF) or reduced (HF-LEF) ejection fraction.

Main Methods:

• Retrospective review of 358 heart failure patients from an advanced heart disease practice.
• Classification into HF-PEF (EF ≥40%), HF-REF (EF recovered to ≥40%), and HF-LEF (EF <40%).
• Comparison of clinical and echocardiographic characteristics across groups.

Main Results:

• HF-REF patients (n=121) were younger, with less comorbidity (atrial fibrillation, hypertension, diabetes) than HF-PEF (n=56).
• HF-REF patients showed characteristics similar to HF-LEF (n=181) but were younger with less coronary artery disease.
• HF-REF patients reported milder HF symptoms and fewer hospitalizations.

Conclusions:

• Patients with recovered ejection fraction (HF-REF) constitute a substantial group in ambulatory HF practices.
• HF-REF patients are clinically distinct and represent a target population for future research.