Recovered heart failure with reduced ejection fraction and outcomes: a prospective study

Area of Science:

• Cardiology
• Heart Failure Research
• Clinical Outcomes

Background:

• A significant proportion of patients with heart failure and reduced ejection fraction (HFrEF) experience recovery of left ventricular ejection fraction (LVEF).
• Outcomes in this 'recovered' group, including mortality and hospitalizations, require detailed analysis.

Purpose of the Study:

• To analyze mortality (all-cause, cardiovascular, HF-related, sudden death) and HF-related hospitalizations in patients who recovered LVEF.
• To compare outcomes between HF-recovered, HF with preserved EF (HFpEF), and persistent HFrEF groups.

Main Methods:

• 1057 HF patients were assessed for LVEF at baseline and 1 year.
• Patients were categorized into HF-recovered (LVEF <45% to ≥45%), HFpEF (LVEF ≥45%), and HFrEF (LVEF <45%) groups.
• Outcomes were analyzed over a mean follow-up of 5.6 years, with non-CV death as a competing risk.

Main Results:

• One in four treated HFrEF patients showed systolic function recovery (HF-recovered group, n=233).
• HF-recovered patients had significantly lower risks for the primary composite endpoint (CV death or HF hospitalization) compared to HFpEF (HR 2.33) and HFrEF (HR 1.99) groups.
• All-cause, CV, HF-related, and sudden death, as well as recurrent HF hospitalizations, were significantly lower in the HF-recovered group versus HFrEF.

Conclusions:

• Recovery of systolic function is achievable in a substantial portion of HFrEF patients.
• HF-recovered patients demonstrate significantly improved mortality and morbidity outcomes compared to HFpEF and HFrEF patients.
• Further research is warranted to determine optimal medical and device therapies for HF-recovered individuals.