Heart failure & cardiomyopathiesCohort study
Epidemiology, clinical characteristics, and outcomes for heart failure with improved ejection fraction by chronological age
- Cohort study
- Kaiser Permanente Northern California (KPNC)
- Cox proportional hazards models adjusted for sex, race, and EF at the time of incident HFrEF
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
Main finding
As reported in the abstract
HFimpEF incidence by age
- 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
Summarised from the published abstract; every number is checked against it