ArticleOpen heart2023
Early prediction of left ventricular function improvement in patients with new-onset heart failure and presumed non-ischaemic aetiology.
Article in Open heart, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 6 citations in OpenAlex.
- Impact of rate-pressure product correction of myocardial blood flow on the prognostic relevance in patients with heart failure.European heart journal. Cardiovascular Imaging · 2026Article
- Article
- An Observational Study of Evidence-Based Therapies in Older Patients with Heart Failure with Reduced Ejection Fraction: Insights from a Dedicated Heart Failure Clinic.Journal of clinical medicine · 2024Article
- Compliance with Guideline-Directed Medical Therapy and Early Implantable Cardioverter-Defibrillator Activation in Heart Failure: A Retrospective Study.Reviews in cardiovascular medicine · 2024Article
- CMR characterization of patients with heart failure and left bundle branch block.European heart journal. Imaging methods and practice · 2024Article
- Clinical Perspective of Myocardial Recovery and Improvement: Definitions, Prevalence, and Relevance.Methodist DeBakey cardiovascular journal · 2024Review
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Authors and funding
13 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesTo determine baseline characteristics predictive of left ventricular ejection fraction (LVEF) recovery in patients diagnosed with heart failure with reduced ejection fraction (HFrEF) and presumed non-ischaemic aetiology.
methodsWe prospectively recruited patients who were diagnosed with HFrEF (LVEF ≤40%) on echocardiography and subsequently underwent cardiac MRI. Patients were excluded if they had a known history of coronary artery disease (>70% on invasive coronary angiography), myocardial infarction, coronary revascularisation or anginal symptoms. At cardiac MRI assessment, patients were categorised as either ongoing HFrEF or heart failure with improved ejection fraction (HFimpEF, LVEF >40% with ≥10% of absolute improvement). Clinical characteristics were compared between the groups. Logistic regression was performed to identify variables that were associated with LVEF recovery. Optimal cut-offs in QRISK3 score and baseline LVEF for prediction of LVEF recovery were identified through receiver operating characteristic curve analysis.
resultsA total of 407 patients were diagnosed with HFrEF, and 139 (34%) attained HFimpEF at cardiac MRI assessment (median 63 days, IQR 41-119 days). Mean age of the patients was 63±12 years, and 260 (63.9%) were male. At multivariate logistic regression, both QRISK3 score (HR 0.978; 95% CI 0.963 to 0.993, p=0.004) and baseline LVEF (HR 1.044; 95% CI 1.015 to 1.073, p=0.002) were independent predictors of HFimpEF. Among patients with baseline LVEF ≤25%, only 22 (21.8%) recovered. In patients with baseline LVEF 25-40%, QRISK3 score >18% was associated with lack of recovery (HR 2.75; 95% CI 1.70 to 4.48, p<0.001). Additionally, QRISK3 score was associated with the presence of ischaemic late gadolinium enhancement (HR 1.035; 95% CI 1.018 to 1.053, p<0.001).
conclusionsThe QRISK3 score helps identify patients with HFrEF with undiagnosed vascular disease. Patients with either a very low baseline LVEF or a high QRISK3 score have less chance of left ventricular recovery and should be prioritised for early cardiac MRI and close monitoring.
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