Left Ventricular End-Systolic Diameter May Predict Persistent Heart Failure with Reduced Ejection Fraction.

Area of Science:

• Cardiology
• Echocardiography
• Heart Failure Research

Background:

• Persistent heart failure with reduced ejection fraction (HFrEF) is associated with worse patient prognosis compared to HF with improved ejection fraction (HFimpEF).
• Limited data exists on echocardiographic predictors for identifying persistent HFrEF.
• Echocardiography is a key imaging modality for assessing cardiac structure and function in heart failure patients.

Purpose of the Study:

• To evaluate the predictive value of echocardiographic parameters at hospital discharge for identifying persistent HFrEF at 1-year follow-up.
• To identify specific echocardiographic markers that can stratify risk in HFrEF patients.
• To determine if echocardiographic findings can aid in clinical decision-making for advanced HF management.

Main Methods:

• Retrospective analysis of 443 patients initially diagnosed with HFrEF (EF ≤ 40%).
• Echocardiography performed at discharge and 1-year follow-up to categorize patients into persistent HFrEF or HFimpEF (EF > 40%).
• Statistical analyses including Kaplan-Meier, receiver operating characteristic (ROC) curve, and multivariable logistic regression were used to assess predictive values.

Main Results:

• Of 443 patients, 68% (301) had persistent HFrEF and 32% (142) had HFimpEF at 1-year follow-up.
• Left ventricular end-systolic diameter (LVESD) demonstrated the highest predictive accuracy (AUC: 0.70) for persistent HFrEF, with a cutoff of 55 mm.
• An LVESD ≥ 55 mm at discharge was an independent predictor of persistent HFrEF (OR: 1.07) and was associated with a higher incidence (81% vs. 55%) compared to LVESD < 55 mm.

Conclusions:

• An LVESD of 55 mm or greater at hospital discharge is significantly associated with persistent HFrEF at 1-year follow-up.
• LVESD measurement is a valuable tool for risk stratification in HFrEF patients.
• Incorporating LVESD assessment into clinical practice may improve management decisions for advanced HF refractory to standard therapies.