Early prediction of left ventricular function improvement in patients with new-onset heart failure and presumed non-ischaemic aetiology

作者：Ze Ming Goh, Wasim Javed, Mubien Shabi, Joel Klassen, Christopher Saunderson, Jonathan Farley, Melanie Spurr, Erica Dall’Armellina, Eylem Levelt, John P. Greenwood, Brian P. Halliday, Sven Plein, Peter Swoboda · 发表于：Open Heart · 年份：2023 · DOI：10.1136/openhrt-2023-002429 · 被引用次数：8 · 研究领域：Cardiovascular Function and Risk Factors、Cardiac Imaging and Diagnostics、Heart Failure Treatment and Management

OBJECTIVES: To determine baseline characteristics predictive of left ventricular ejection fraction (LVEF) recovery in patients diagnosed with heart failure with reduced ejection fraction (HFrEF) and presumed non-ischaemic aetiology. METHODS: We prospectively recruited patients who were diagnosed with HFrEF (LVEF ≤40%) on echocardiography and subsequently underwent cardiac MRI. Patients were excluded if they had a known history of coronary artery disease (>70% on invasive coronary angiography), myocardial infarction, coronary revascularisation or anginal symptoms. At cardiac MRI assessment, patients were categorised as either ongoing HFrEF or heart failure with improved ejection fraction (HFimpEF, LVEF >40% with ≥10% of absolute improvement). Clinical characteristics were compared between the groups. Logistic regression was performed to identify variables that were associated with LVEF recovery. Optimal cut-offs in QRISK3 score and baseline LVEF for prediction of LVEF recovery were identified through receiver operating characteristic curve analysis. RESULTS: A total of 407 patients were diagnosed with HFrEF, and 139 (34%) attained HFimpEF at cardiac MRI assessment (median 63 days, IQR 41-119 days). Mean age of the patients was 63±12 years, and 260 (63.9%) were male. At multivariate logistic regression, both QRISK3 score (HR 0.978; 95% CI 0.963 to 0.993, p=0.004) and baseline LVEF (HR 1.044; 95% CI 1.015 to 1.073, p=0.002) were independent predictors of HFimpEF. Among patients ...