The following is a summary of “Factors Associated With Maintenance of an Improved Ejection Fraction: An Echocardiogram‐Based Registry Study,” published in the October 2023 issue of Cardiology by McElderry et al.

Heart failure with improved ejection fraction (EF) is increasingly acknowledged as a distinct condition within the medical landscape. While the factors contributing to improved EF have garnered attention and new guidelines have emerged, the key elements sustaining this improvement over time remain undefined. Their objective was to delve into the factors linked with maintaining an improved EF in a large-scale, real-world patient cohort.

Conducting a retrospective cohort study at the Cleveland Clinic in Cleveland, Ohio, the researchers included 7,070 participants with heart failure exhibiting improved EF, subsequently undergoing echocardiograms after a minimum follow-up of 9 months. Multiple logistic regression models, adjusted for demographics, comorbidities, and medications, were employed to pinpoint the characteristics and therapeutic approaches associated with sustaining improved EF. Among the participants (mean age [SD]: 64.9 [13.8] years; 62.7% men; 75.1% White), findings indicated that White race and the use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, or angiotensin receptor-neprilysin inhibitors were linked to sustaining EF at least 9 months after the initial improvement. Conversely, male gender, atrial fibrillation/flutter, coronary artery disease, prior myocardial infarction, presence of an implanted cardioverter-defibrillator, and usage of loop diuretics were associated with a decline in EF following the documented improvement.

In conclusion, their study suggests that the continued use of renin–angiotensin–aldosterone system inhibitors plays a role in maintaining EF beyond the initial improvement phase.

Source: ahajournals.org/doi/10.1161/JAHA.123.031093