Heart failure & cardiomyopathiesCohort study
A U-Shaped Relationship Between Left Ventricular Ejection Fraction and Risk of Worsening Heart Failure
- Retrospective cohort study
- single-centre
- consecutive participants
Authors' conclusion
Left ventricular ejection fraction demonstrated a U-shaped association with worsening HF, with the lowest risk at 60-70%. Supranormal LVEF (≥70%) identified a high-risk phenotype
Study context
- Population
- Consecutive participants undergoing echocardiography at a tertiary medical centre
- Participants
- 93,694 participants
- Exposure
- Left ventricular ejection fraction (LVEF) categories
- Outcome
- Composite of:
- All-cause mortality
- Worsening HF
- Follow-up
- Median 8.3 years
Main finding
All-cause mortality or worsening HF
Adjusted hazard ratio
1.12
95% CI 1.06–1.18
LVEF ≥70% vs LVEF 60-70%
aHR 1.12 (95% CI 1.06–1.18)
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aHR (95% CI) | |
|---|---|---|
| Worsening HF | 1.13 (1.03–1.23) | |
| 0.512Adjusted hazard ratio (log scale) |
All-cause mortality, CV death, worsening heart failure (HF)
- Similar patterns observed for the secondary outcomes
Subgroups (age, sex, hypertension, diabetes); incident and recurrent HF events
- U-shaped association consistent across subgroups and for incident and recurrent HF events
Original publication
A U-Shaped Relationship Between Left Ventricular Ejection Fraction and Risk of Worsening Heart Failure. Eur J Heart Fail. Published 20 October 2025. doi:10.1002/ejhf.70061
Summarised from the published abstract; every number is checked against it