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Factors and outcomes associated with improved left ventricular systolic function in patients with cardiomyopathy

Dylan S Eiger1, Lurdes Y T Inoue2, Qijun Li2

  • 1Department of Medicine, Duke University, Durham, NC, USA. dylan.eiger@duke.edu.

Cardiology Journal
|January 13, 2021
PubMed

Insights

A significant improvement in left ventricular ejection fraction (LVEF) was observed in about a third of heart failure patients. This LVEF improvement correlated with better survival and fewer implantable cardioverter-defibrillator shocks.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Clinical Trials

Background:

  • Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) identified patients with improved left ventricular ejection fraction (LVEF).
  • Factors and outcomes linked to LVEF improvement in heart failure patients remain unclear.

Purpose of the Study:

  • To investigate factors associated with LVEF improvement in heart failure patients.
  • To determine the impact of LVEF improvement on mortality, cause-specific mortality, and implantable cardioverter-defibrillator (ICD) shocks.

Main Methods:

  • Analysis of SCD-HeFT participants randomized to placebo or ICD with follow-up LVEF measurements.
  • Statistical examination of factors correlating with LVEF increase and subsequent clinical outcomes.

Main Results:

  • 33% of patients (276/837) showed >10% LVEF improvement over a median of 3.99 years.
  • Factors linked to LVEF improvement: female sex, white race, hypertension history, QRS duration <120 ms, beta-blocker use.
  • LVEF improvement correlated with enhanced survival and reduced appropriate ICD shocks, but not cause-specific death.

Conclusions:

  • Significant LVEF improvement occurred in approximately one-third of SCD-HeFT participants.
  • LVEF improvement is associated with better survival and a lower likelihood of ICD shocks.
  • LVEF improvement did not show a significant association with cause-specific mortality.
Abstract

Keywords:
arrhythmiadefibrillatorheart failureimplantablesudden cardiac death

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