ArticleESC heart failure2025
Impact of early intensive GDMT on LVEF recovery and ICD decision making in de novo HFrEF.
Article in ESC heart failure, 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.
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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.
- Landmark clinical trials shaping contemporary guideline-directed medical therapy for heart failure.ESC heart failure · 2026Review
- Impact of early intensive GDMT on LVEF recovery and ICD decision making in de novo HFrEF.ESC heart failure · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
aimsImplantable cardioverter-defibrillator (ICD) implantation is recommended in patients with heart failure with reduced ejection fraction (HFrEF) and left ventricular ejection fraction (LVEF) ≤ 35% after 3 months of optimized medical therapy (OMT). Whether recent advances in guideline-directed medical therapy (GDMT), including angiotensin receptor-neprilysin inhibitors (ARNI) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) alter the timing of ICD implantation remains uncertain.
methodsIn this single-centre, prospective cohort study, 106 patients with newly diagnosed HFrEF (mean age 63 ± 13 years; 25% women; 53% non-ischaemic aetiology) and baseline LVEF ≤35% were enrolled between 2019 and 2022. Echocardiographic assessments were performed at baseline, 3 months and 12 months to evaluate LVEF improvement. The primary endpoint was LVEF recovery >35% between 90 days and 1 year.
resultsBaseline mean LVEF was 27%. At 3 months, mean LVEF increased to 37% (P < 0.001), and 58% of patients achieved LVEF >35%. These patients showed further improvement to a median LVEF of 45% at 12 months. Among those with LVEF ≤35% at 3 months (n = 44), only eight patients (18%) recovered by 12 months, six of whom received cardiac resynchronization therapy. The rapid initiation and optimization of GDMT, particularly ARNI and SGLT2i, was associated with early LVEF improvement.
conclusionsEarly and intensive GDMT optimization resulted in significant LVEF improvement within the first 3 months post-diagnosis for most patients. Those who failed to recover by this point exhibited limited improvement by 1 year. These findings suggest that the conventional 3 month window for ICD decision making remains appropriate, despite advancements in heart failure therapy.
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