Incidence and determinants of left ventricular ejection fraction (LVEF) recovery in heart failure with reduced ejection fraction (HFrEF) of non-ischemic aetiology; a hospital-based prospective longitudinal registry study
Background: Heart failure with reduced ejection fraction (HFrEF) can show recovery in some patients, especially with non-ischemic causes, leading to better outcomes. Recovery varies due to factors like aetiology and severity of myocardial injury. This study examines the incidence and predictors of l...
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Elsevier
2025-05-01
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| Series: | Indian Heart Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0019483225000628 |
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| author | Sanjeev Kumar Prakash Chand Negi Sanjeev Asotra Jitender Kumar Rajeev Merwah Rajesh Sharma Ritesh Kumar Vinay Bhardwaj Preetam Singh Thakur |
| author_facet | Sanjeev Kumar Prakash Chand Negi Sanjeev Asotra Jitender Kumar Rajeev Merwah Rajesh Sharma Ritesh Kumar Vinay Bhardwaj Preetam Singh Thakur |
| author_sort | Sanjeev Kumar |
| collection | DOAJ |
| description | Background: Heart failure with reduced ejection fraction (HFrEF) can show recovery in some patients, especially with non-ischemic causes, leading to better outcomes. Recovery varies due to factors like aetiology and severity of myocardial injury. This study examines the incidence and predictors of left ventricular ejection fraction (LVEF) recovery in non-ischemic HFrEF patients. Methods: This was a prospective observational study conducted at a tertiary care hospital, involving 500 patients with non-ischemic HFrEF (baseline LVEF <40 %). Patients were followed for a duration of 8 years (2011–2023) with periodic clinical assessments and annual echocardiographic evaluations. Data on comorbidities, baseline cardiac function, medication adherence, and clinical events were collected. The incidence rate of LVEF recovery was determined, and Kaplan–Meier survival analysis was used to identify recovery trends over time. Predictors of recovery were evaluated using Cox proportional hazards models. Results: Cumulative incidence of LVEF recovery was 27.4 % (95 % CI: 23.7–31.5) at 8 years, with an incidence rate of 4.5 per 100 person-years. Higher baseline LVEF (≥30 %) strongly predicted recovery (HR: 2.17, p < 0.001), while dilated LV (LVEDD ≥60 mm, HR: 0.6, p = 0.02) and diabetes (HR: 0.36, p = 0.01) were associated with lower recovery. Education (≥Class 5) was linked to better recovery (HR: 1.45, p = 0.04). Beta-blockers showed a potential but nonsignificant benefit. Conclusion: Nearly one-fourth (27.4 %) of patients achieved LVEF recovery over 8 years, with higher baseline LVEF and education associated with better outcomes, while adverse cardiac remodeling and diabetes were linked to lower recovery. |
| format | Article |
| id | doaj-art-ae7d3e7b5b994ef5aae5d41f31c4966e |
| institution | OA Journals |
| issn | 0019-4832 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
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| series | Indian Heart Journal |
| spelling | doaj-art-ae7d3e7b5b994ef5aae5d41f31c4966e2025-08-20T02:37:10ZengElsevierIndian Heart Journal0019-48322025-05-0177318819210.1016/j.ihj.2025.03.016Incidence and determinants of left ventricular ejection fraction (LVEF) recovery in heart failure with reduced ejection fraction (HFrEF) of non-ischemic aetiology; a hospital-based prospective longitudinal registry studySanjeev Kumar0Prakash Chand Negi1Sanjeev Asotra2Jitender Kumar3Rajeev Merwah4Rajesh Sharma5Ritesh Kumar6Vinay Bhardwaj7Preetam Singh Thakur8Corresponding author. Department of Cardiology, IGMC, Room No.310, Shimla, India.; Department of Cardiology, IGMC, Shimla, IndiaDepartment of Cardiology, IGMC, Shimla, IndiaDepartment of Cardiology, IGMC, Shimla, IndiaDepartment of Cardiology, IGMC, Shimla, IndiaDepartment of Cardiology, IGMC, Shimla, IndiaDepartment of Cardiology, IGMC, Shimla, IndiaDepartment of Cardiology, IGMC, Shimla, IndiaDepartment of Cardiology, IGMC, Shimla, IndiaDepartment of Cardiology, IGMC, Shimla, IndiaBackground: Heart failure with reduced ejection fraction (HFrEF) can show recovery in some patients, especially with non-ischemic causes, leading to better outcomes. Recovery varies due to factors like aetiology and severity of myocardial injury. This study examines the incidence and predictors of left ventricular ejection fraction (LVEF) recovery in non-ischemic HFrEF patients. Methods: This was a prospective observational study conducted at a tertiary care hospital, involving 500 patients with non-ischemic HFrEF (baseline LVEF <40 %). Patients were followed for a duration of 8 years (2011–2023) with periodic clinical assessments and annual echocardiographic evaluations. Data on comorbidities, baseline cardiac function, medication adherence, and clinical events were collected. The incidence rate of LVEF recovery was determined, and Kaplan–Meier survival analysis was used to identify recovery trends over time. Predictors of recovery were evaluated using Cox proportional hazards models. Results: Cumulative incidence of LVEF recovery was 27.4 % (95 % CI: 23.7–31.5) at 8 years, with an incidence rate of 4.5 per 100 person-years. Higher baseline LVEF (≥30 %) strongly predicted recovery (HR: 2.17, p < 0.001), while dilated LV (LVEDD ≥60 mm, HR: 0.6, p = 0.02) and diabetes (HR: 0.36, p = 0.01) were associated with lower recovery. Education (≥Class 5) was linked to better recovery (HR: 1.45, p = 0.04). Beta-blockers showed a potential but nonsignificant benefit. Conclusion: Nearly one-fourth (27.4 %) of patients achieved LVEF recovery over 8 years, with higher baseline LVEF and education associated with better outcomes, while adverse cardiac remodeling and diabetes were linked to lower recovery.http://www.sciencedirect.com/science/article/pii/S0019483225000628Heart failureLeft ventricular ejection fractionHeart failure with reduced ejection fractionGuideline-directed medical therapyCoronary artery diseasetype 2 diabetes mellitus |
| spellingShingle | Sanjeev Kumar Prakash Chand Negi Sanjeev Asotra Jitender Kumar Rajeev Merwah Rajesh Sharma Ritesh Kumar Vinay Bhardwaj Preetam Singh Thakur Incidence and determinants of left ventricular ejection fraction (LVEF) recovery in heart failure with reduced ejection fraction (HFrEF) of non-ischemic aetiology; a hospital-based prospective longitudinal registry study Indian Heart Journal Heart failure Left ventricular ejection fraction Heart failure with reduced ejection fraction Guideline-directed medical therapy Coronary artery disease type 2 diabetes mellitus |
| title | Incidence and determinants of left ventricular ejection fraction (LVEF) recovery in heart failure with reduced ejection fraction (HFrEF) of non-ischemic aetiology; a hospital-based prospective longitudinal registry study |
| title_full | Incidence and determinants of left ventricular ejection fraction (LVEF) recovery in heart failure with reduced ejection fraction (HFrEF) of non-ischemic aetiology; a hospital-based prospective longitudinal registry study |
| title_fullStr | Incidence and determinants of left ventricular ejection fraction (LVEF) recovery in heart failure with reduced ejection fraction (HFrEF) of non-ischemic aetiology; a hospital-based prospective longitudinal registry study |
| title_full_unstemmed | Incidence and determinants of left ventricular ejection fraction (LVEF) recovery in heart failure with reduced ejection fraction (HFrEF) of non-ischemic aetiology; a hospital-based prospective longitudinal registry study |
| title_short | Incidence and determinants of left ventricular ejection fraction (LVEF) recovery in heart failure with reduced ejection fraction (HFrEF) of non-ischemic aetiology; a hospital-based prospective longitudinal registry study |
| title_sort | incidence and determinants of left ventricular ejection fraction lvef recovery in heart failure with reduced ejection fraction hfref of non ischemic aetiology a hospital based prospective longitudinal registry study |
| topic | Heart failure Left ventricular ejection fraction Heart failure with reduced ejection fraction Guideline-directed medical therapy Coronary artery disease type 2 diabetes mellitus |
| url | http://www.sciencedirect.com/science/article/pii/S0019483225000628 |
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