Clinical, Echocardiographic, and Longitudinal Characteristics Associated With Heart Failure With Improved Ejection Fraction

作者：Erick Romero, Alexander Baltodano, Paulo Rocha, Camryn Sellers-Porter, Dev Jaydeep Patel, Saad Soroya, Julie T. Bidwell, Imo Ebong, Michael Gibson, David Liem, Shirin Jimenez, Heejung Bang, Padmini Sirish, Nipavan Chiamvimonvat, Javier E. López, Martín Cadeiras · 发表于：The American Journal of Cardiology · 年份：2023 · DOI：10.1016/j.amjcard.2023.10.086 · 被引用次数：19 · 研究领域：Cardiovascular Function and Risk Factors、Heart Failure Treatment and Management、Cardiac pacing and defibrillation studies

Heart failure with improved ejection fraction (HFimpEF) has better outcomes than HF with reduced EF (HFrEF). However, factors contributing to HFimpEF remain unclear. This study aimed to evaluate clinical and longitudinal characteristics associated with subsequent HFimpEF. This was a single-center retrospective HFrEF cohort study. Data were collected from 2014 to 2022. Patients with HFrEF were identified using International Classification of Diseases codes, echocardiographic data, and natriuretic peptide levels. The main end points were HFimpEF (defined as EF >40% at ≥3 months with ≥10% increase) and mortality. Cox proportional hazards and mixed effects models were used for analyses. The study included 1,307 patients with HFrEF with a median follow-up of 16.3 months (interquartile range 8.0 to 30.6). The median age was 65 years; 68% were male whereas 57% were White. On follow-up, 38.7% (n = 506) developed HFimpEF, whereas 61.3% (n = 801) had persistent HFrEF. A multivariate Cox regression model identified gender, race, co-morbidities, echocardiographic, and natriuretic peptide as significant covariates of HFimpEF (p <0.05). The HFimpEF group had better survival compared with the persistent HFrEF group (p <0.001). Echocardiographic and laboratory trajectories differed between groups. In this HFrEF cohort, 38.7% transitioned to HFimpEF and approximately 50% met the definition within the first 12 months. In a HFimpEF model, gender, co-morbidities, echocardiographic parameters, an...