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[Heart failure with improved ejection fraction: practical guidance for the clinician]
Mauro Gori1, Maria Denitza Tinti2, Piero Gentile3
1U.O.C. Cardiologia 1, Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo - Area Scompenso Cardiaco ANMCO.
Giornale Italiano Di Cardiologia (2006)
|December 12, 2022
Summary
Heart failure with improved ejection fraction (HFimpEF) is a growing patient group. Continued medical therapy is crucial after ejection fraction recovery to prevent worsening outcomes and requires careful consideration for device implantation.
Area of Science:
- Cardiology
- Heart Failure Research
Background:
- Heart failure with improved ejection fraction (HFimpEF) is a recently recognized clinical entity.
- Increasing incidence of HFimpEF is observed, linked to advancements in heart failure with reduced ejection fraction (HFrEF) medical therapy.
- Continued medical therapy post-ejection fraction recovery is vital to prevent relapse and adverse outcomes.
Purpose of the Study:
- To highlight the growing clinical significance of HFimpEF.
- To discuss the controversial optimal management strategies for HFimpEF.
- To emphasize the need for careful consideration regarding device implantation timing in HFimpEF patients.
Main Methods:
- Review of current literature and recent clinical trial data, including the DELIVER trial.
- Analysis of data on myocardial recovery rates and timelines in HFrEF patients.
- Consideration of the implications for therapeutic interventions.
Main Results:
- HFimpEF represents a significant and increasing patient subgroup.
- Myocardial recovery in HFrEF patients can occur in up to 40% of cases within 12 months.
- The DELIVER trial is a recent randomized study that included HFimpEF patients.
Conclusions:
- Continued medical therapy is essential for HFimpEF patients to maintain improved ejection fraction and prevent recurrence.
- The optimal timing for interventions like defibrillator implantation in HFimpEF requires further investigation.
- Further research is needed to establish best management practices for this evolving patient population.
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