Reduction in Left Ventricular Ejection Fraction is Associated with Subsequent Cardiac Events in Outpatients with...

Area of Science:

• Cardiology
• Heart Failure Research
• Clinical Outcomes

Background:

• Left ventricular ejection fraction (LVEF) is a key prognostic marker in heart failure (HF).
• The impact of serial LVEF changes in stable chronic heart failure (CHF) requires further investigation.
• Understanding LVEF dynamics is crucial for refining patient management strategies.

Purpose of the Study:

• To investigate the prognostic significance of serial LVEF changes in patients with stable chronic heart failure (CHF).
• To identify a threshold for LVEF reduction that predicts adverse cardiac events.
• To determine if LVEF changes independently predict future cardiac events.

Main Methods:

• Analysis of data from 263 outpatients with CHF from the J-MELODIC study cohort.
• Stratification of patients into tertiles based on relative LVEF difference over 1 year compared to baseline.
• Receiver operating characteristics (ROC) analysis to determine the optimal LVEF reduction cutoff value.

Main Results:

• A significant difference in cardiac event rates was observed among LVEF change groups (log-rank test, p=0.042).
• An 11% relative LVEF reduction was identified as the optimal cutoff for predicting adverse events.
• Baseline LVEF and E/e' predicted >11% LVEF reduction, which was an independent predictor of subsequent cardiac events (HR 5.79, p<0.001).

Conclusions:

• A 1-year relative LVEF reduction exceeding 11% is associated with worsening outcomes in CHF patients.
• Patients experiencing significant LVEF decline represent a high-risk population for cardiac events.
• Close follow-up is recommended for CHF patients with a >11% relative LVEF reduction.