Heart failure & cardiomyopathies
Long-Term Outcomes and Reverse Remodelling in Recently Diagnosed Unexplained Left Ventricular Systolic Dysfunction
Authors' conclusion
LVRR occurs in over half of patients with recent onset unexplained LV systolic dysfunction during first 2 years of optimally guided heart failure therapy and then remains relatively stable during 5-year follow-up. Normalization of adverse LV remodelling corresponds to a low rate of mortality and heart failure hospitalizations during long-term follow-up.
Study context
- Population
- Recently diagnosed unexplained LV systolic dysfunction (HF symptoms <6 months, LVEF <40% after ≥1 week of therapy), all with endomyocardial biopsy at diagnosis37 women
- Participants
- 133 participants
- Outcome
- Long-term clinical course and stability of LV reverse remodelling (LVRR)
- Follow-up
- 5 years
Main finding
As reported in the abstract
Left ventricular reverse remodelling (LVRR) at 1 year
46%
LVRR at 2 years
60%
LVRR at 5 years
50%
Observational data: associations, not effects.
Further findings
Independent predictors of mortality (multivariate)
| OR (CI) | P value | ||
|---|---|---|---|
| Baseline right atrial size | 1.097 (1.007–1.196) | P < 0.05 | |
| logBNP level | 2.02 (1.14–3.56) | P < 0.05 | |
| PR interval | 1.02 (1.006–1.035) | P < 0.05 | |
| 0.20.5125Odds ratio (log scale) |
Independent predictors of LVRR (multivariate)
| OR (CI) | P value | ||
|---|---|---|---|
| LV end-diastolic volume index | 0.97 (0.946–0.988) | P < 0.05 | |
| LVEF | 0.89 (0.83–0.96) | P < 0.05 | |
| DBP | 1.04 (1.01–1.08) | P < 0.05 | |
| 0.512Odds ratio (log scale) |
Clinical events · 5 years
- Death
- 23 (17%)
- Heart transplantation
- 2%
- HF hospitalization
- 12%
Independent predictors of mortality (multivariate)
- Macrophage number on endomyocardial biopsy (EMB) associated with overall survival in univariate analysis only
Mortality and HF hospitalization by LVRR at 1 year
- LVRR at 1 year associated with lower rate of mortality and HF hospitalization
- P = 0.025
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →