Predictors of Left Ventricular Reverse Remodeling in Heart Failure with Reduced Ejection Fraction

While left ventricular (LV) remodeling has been associated with poor prognosis in heart failure with reduced ejection, a variable degree of LV remodeling can be reversed upon the removal of the initial insult and with appropriate therapies. Hence, better prediction of LV reverse remodeling would not only help prognostically, but also could illuminate potential therapeutic targets. Herein, we provide a comprehensive review on the latest evidence on the predictors of LV reverse remodeling.

Several predictors of LV reverse remodeling have been identified including certain baseline parameters of underlying cardiomyopathy, myocardial structure and function assessed by multi-modality imaging, and biomarkers. Beyond improving clinical outcomes, many of the established and emerging heart failure therapies have been also demonstrated to promote reverse remodeling, likely reflective of the mechanistic underpinning of their therapeutics benefits. With the ongoing development of novel diagnostics and therapies of heart failure, our understanding of LV reverse remodeling continues to evolve. Furthermore, with the growing evidence between reverse remodeling and clinical outcomes, reverse remodeling may prove to be a clinically useful marker of myocardial recovery and potential therapeutic target.