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Heart failure with recovered ejection fraction: clinical characteristics, determinants and prognosis. CARDIOCHUS-CHOP registry.

Heart failure with recovered ejection fraction: clinical characteristics, determinants and prognosis. CARDIOCHUS-CHOP registry.
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Agra Bermejo R, Gonzalez Babarro E, López Canoa JN, Varela Román A, Gómez Otero I, Oro Ayude M, Parada Vazquez P, Gómez Rodríguez I, Díaz Castro O, González Juanatey JR,


Agra Bermejo R, Gonzalez Babarro E, López Canoa JN, Varela Román A, Gómez Otero I, Oro Ayude M, Parada Vazquez P, Gómez Rodríguez I, Díaz Castro O, González Juanatey JR, (click to view)

Agra Bermejo R, Gonzalez Babarro E, López Canoa JN, Varela Román A, Gómez Otero I, Oro Ayude M, Parada Vazquez P, Gómez Rodríguez I, Díaz Castro O, González Juanatey JR,

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Cardiology journal 2017 10 05() doi 10.5603/CJ.a2017.0103
Abstract
BACKGROUND
The magnitude and the prognostic impact of recovering left ventricular ejection fraction (LVEF) in patients with heart failure (HF) and systolic dysfunction is unclear. The aim of this study was to evaluate the clinical characteristics and prognosis of patients with HFrecEF in an HF population.

METHODS
449 consecutive patients were selected with the diagnosis of HF and an evaluation of LVEF in the 6 months prior to selection who were referred to two HF units. Patients with systolic dysfunction were only considered if a second echocardiogram was performed during the follow-up.

RESULTS
At the time of diagnosis, 207 patients had LVEF > 40% (HFpEF) and 242 had LVEF ≤ 40% (HFrEF). After 1 year, the LVEF was re-evaluated in all 242 patients with a LVEF ≤ 40%: in 126 (52%), the second LVEF was > 40% (HFrecEF), and the remaining 116 (48%) had LVEF ≤ 40% (HFrEF). After 1800 ± 900 days of follow-up patients with recovered LVEF had a significantly lower mortality rate (HFpEF vs. HFrecEF: hazard ratio (HR) = 2.286, 95% confidence interval (95% CI) 1.264-4.145, p = 0.019; HFrEF vs. HFrecEF: HR = 2.222, 95% CI 1.189-4.186, p < 0.001) and hospitalization rate (HFpEF vs. HFrecEF: HR = 1.411, 95% CI 1.046-1.903, p = 0.024; HFrEF vs. HFrecEF: HR = 1.388, 95% CI 1.002-1.924, p = 0.049). The following are predictors of LVEF recovery: younger age, lower functional class, treatment with renin-angiotensin-aldosterone system inhibitors and beta-blockers, absence of defibrillator use, and non-ischemic aetiology. CONCLUSIONS
Patients with HF and reduced LVEF who were re-evaluated after 1 year, had significant improvement in their LVEF and had a more favourable prognosis than HF with preserved and reduced ejection fraction.

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