ArticleHeart rhythm2025
Temporal trends in left ventricular ejection fraction before sudden death in patients with heart failure.
Article in Heart rhythm, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Wearable Cardioverter-Defibrillator in Patients at Transient Risk of Sudden Cardiac Death: State of the Art and Contemporary Clinical Evidence.Diagnostics (Basel, Switzerland) · 2026Review
- Predicting sudden cardiac death in heart failure with reduced ejection fraction.Heart failure reviews · 2026Review
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundRisk stratification for sudden cardiac death (SCD) in heart failure (HF) patients is largely based on left ventricular ejection fraction (LVEF) of ≤35%. However, disease-related LV remodeling and medical treatment may change LVEF over time.
objectiveThis study aimed to evaluate the temporal trends in LVEF in patients with HF who experience an SCD.
methodsWe performed 2 retrospective cohort studies (discovery and validation) of patients who experienced SCD after an established diagnosis of HF. Individuals were identified from 2 separate population-based studies of SCD in Oregon and California, if they underwent ≥2 echocardiographic evaluations performed at least 6 months apart.
resultsThe Oregon discovery cohort included 526 patients (male 63.9%; age 70.4 [13.2]), and the California validation cohort 191 patients (male 60.7%; age 74.6 [13.6]). In the discovery cohort, 45% of patients with LVEF of ≤35% on first assessment were reclassified to LVEF of >35% at final assessment (P < .001). Among patients with LVEF of 36%-49%, 66% were reclassified to either ≤35% or >50% (P < .001). In patients with LVEF of >50%, 32% were reclassified to LVEF of <50% (P < .001). Overall, 41.1% of patients in the discovery cohort were reclassified based on LVEF (P < .001). No distinguishing characteristics were identified between patients with an initial LVEF of ≤35% who improved or did not. Similar findings were observed in the validation cohort.
conclusionLVEF category changed significantly over time, resulting in substantial reclassification of risk before the SCD event. These findings highlight the major limitation of using LVEF measured at a single time point as the main predictor of SCD risk.
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