Heart failure & cardiomyopathies

Epidemiology, clinical characteristics, and outcomes for heart failure with improved ejection fraction by chronological age

ESC Heart FailPublished Cohort study

Authors' conclusion

HFimpEF is common within a year of incident HFrEF, more prevalent in younger patients, and is associated with continued residual risk. Compared to persistent HFrEF, improvements in LVEF are associated with lower risk of WHF or death across the age spectrum. Additional research is needed to understand HF symptom burden and medical therapy use in this population to inform shared decision-making.

Study context

Population
Adults ≥18 years with incident HFrEF (LVEF ≤40%) between 2013 and 2022 within Kaiser Permanente Northern Californiaadults with incident HFrEF
Participants
28,292 adults
Exposure
Rates of worsening HF (WHF) events were compared between HF with improved ejection fraction (HFimpEF) and persistent HFrEF patients across age
Outcome
HFimpEF incidence by age
Methodological detailsKaiser Permanente Northern California (KPNC), Cox proportional hazards models adjusted for sex, race, and EF at the time of incident HFrEF
  • Kaiser Permanente Northern California (KPNC)
  • Cox proportional hazards models adjusted for sex, race, and EF at the time of incident HFrEF

Main finding

As reported in the abstract

Overall HFimpEF
35%
<50 yrs
43%
50-64 yrs
42%
65-79 yrs
39%
≥80 yrs
21%

Observational data: associations, not effects.

Further findings

WHF incidence rates (per 100 person-years) by age

<50 yrs
10.6 [95% CI, 9.5-11.7]
50-64 yrs
14.5 [13.7-15.3]
65-79 yrs
20.8 [20.0-21.6]
≥80 yrs
31.7 [29.9-33.5]

Adjusted rates of WHF, HFimpEF vs persistent HFrEF

Lower adjusted rates of WHF with HFimpEF, more prominent at lower ages
  • Pinteraction by age <0.001

Original publication

Epidemiology, clinical characteristics, and outcomes for heart failure with improved ejection fraction by chronological age. ESC Heart Fail. Published 29 July 2026. doi:10.1093/eschf/xvag158

Composed by AI from the published abstract and checked against it. How Briefs are made →

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