Related Experiment Video
Updated: Aug 6, 2026
09:20
Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
Heart Failure With Improved Ejection Fraction in ACHD With Biventricular Physiology and Systemic Left Ventricle
Ahmed E Ali1, Zeyad Kholeif1, Marwan Ahmed1
1Department of Cardiovascular Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA.
JACC. Advances
|July 21, 2026
Summary
Guideline-directed medical therapy (GDMT) improves left ventricular ejection fraction (LVEF) in adults with congenital heart disease (CHD) and heart failure with reduced ejection fraction (HFrEF). This improvement is linked to better survival and fewer cardiovascular events.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Heart Failure Research
Background:
- Guideline-directed medical therapy (GDMT) improves left ventricular ejection fraction (LVEF) in acquired heart disease, but data are limited for congenital heart disease (CHD).
- Heart failure with improved ejection fraction (HFimpEF) is a recognized outcome in acquired heart disease.
- Understanding HFimpEF in CHD is crucial for optimizing patient management.
Purpose of the Study:
- To determine the prevalence of HFimpEF in adults with CHD and systemic left ventricles.
- To identify factors associated with HFimpEF in this population.
- To evaluate the prognostic impact of HFimpEF on mortality and cardiovascular events.
Main Methods:
- Retrospective analysis of adults with CHD, biventricular physiology, and systemic LV with HFrEF (2003-2023).
- Echocardiograms assessed LVEF at baseline and 1-year follow-up; HFimpEF defined as LVEF increase ≥10% (≤40% to >40%).
- GDMT use and uptitration (ΔGDMT) quantified; Cox regression analyzed outcomes.
Main Results:
- 19% (63/327) of patients achieved HFimpEF.
- Higher GDMT use and ΔGDMT were associated with increased odds of HFimpEF.
- HFimpEF correlated with a 26% reduction in all-cause mortality and 28% in cardiovascular events.
Conclusions:
- GDMT is associated with improved LVEF and outcomes in adults with CHD and HFrEF.
- Optimization and adherence to GDMT are recommended for this patient group.
- Ongoing clinical and imaging surveillance is necessary for patients with CHD-related HFimpEF.
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