Heart failure & cardiomyopathies
Predictors of Sustained Reverse Remodelling in Patients with Heart Failure with Reduced Ejection Fraction
Authors' conclusion
Patients with greater EF increases and LVESD reductions at EF recovery, greater septum thickness, higher blood pressure, no need for diuretics and NYHA I/II maintenance had the best chance of maintaining recovered ventricular function.
Study context
- Population
- Patients with heart failure with reduced ejection fraction (HFrEF) and ≥2 consecutive echocardiogramsincluded of 8072 assessed HF patients
- Participants
- 3,628 patients
- Exposure
- Left ventricular EF (LVEF) trajectory: no RR, non-SRR, and SRR
- NSRRn = 310
- SRRn = 1,032
- Outcome
- Improved EF
Methodological detailsreal-life cohort
- Real-life cohort
Main finding
As reported in the abstract
Patients with improved ejection fraction (EF)
1342
37%
NSRR among those who achieved RR
310
23%
SRR among those who achieved RR
1032
77%
Observational data: associations, not effects.
Further findings
| Outcome | OR (CI) | P value | |
|---|---|---|---|
| Independent predictors of SRR (logistic multivariable regression)Second LVEF · per unit · multivariable | 1.06 (1.03–1.90) | P < 0.001 | |
| Independent predictors of SRR (logistic multivariable regression)Second LVESD · per unit · multivariable | 0.93 (0.90–0.96) | P < 0.001 | |
| Independent predictors of SRR (logistic multivariable regression)Second IV septum thickness · per unit · multivariable | 1.12 (1.03–1.23) | P = 0.012 | |
| Independent predictors of SRR (logistic multivariable regression)Systolic blood pressure · per unit · multivariable | 1.01 (1.00–1.02) | P = 0.014 | |
| 0.512Odds ratio (log scale) |
Independent predictors of SRR (logistic multivariable regression)
| OR (CI) | P value | ||
|---|---|---|---|
| NYHA I-IIMultivariable | 1.86 (1.27–2.74) | P = 0.001 | |
| Furosemide non-useMultivariable | 1.87 (1.27–2.74) | P < 0.001 | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | NRR | NSRR | SRR |
|---|---|---|---|
| Survival after the second echocardiogram | mean 9.8 (SE 0.2) years | mean 10.6 (SE 0.5) | mean 12.2 (SE 0.3) years |
- Survival after the second echocardiogram — Mean (±SE) survival overall
- 10.6 (±0.2) years
- Survival after the second echocardiogram: P < 0.001
Baseline characteristics
- Mean age
- 56.2 (±13.4) years
- Male
- 64.4%
- New York Heart Association (NYHA) I-II
- 77.7%
Original publication
Predictors of Sustained Reverse Remodelling in Patients with Heart Failure with Reduced Ejection Fraction. ESC Heart Fail. Published 10 February 2025. doi:10.
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