Abstract 12152: The Association of Improvement in Left Ventricular Ejection Fraction With Outcomes in Patients With Heart Failure With Reduced Ejection Fraction - Data From CHAMP-HF

Abstract

Background: Among patients with heart failure with reduced ejection fraction (HFrEF), improvements in left ventricular EF (LVEF) are associated with better outcomes in select populations. How changes in LVEF are associated with outcomes in routine clinical practice is not clearly defined. Methods: CHAMP-HF was a prospective registry of US outpatients with HF and an LVEF < 40%. Enrolled patients completed the Kansas City Cardiomyopathy Questionnaire 12-item questionnaire (KCCQ-12) at regular intervals and were followed as part of routine care for assessments of LVEF and clinical outcomes. We analyzed all patients with baseline and > 1 LVEF assessment during follow-up, and we assessed for associations between improvements in LVEF ( > 5%) over time and concurrent changes in KCCQ-12 and subsequent risk of HF hospitalization or all-cause death. Results: Among patients enrolled in CHAMP-HF, 2092 had a baseline and follow-up LVEF assessment. The median age was 67 years (25 th , 75 th percentile 58, 75), 29% were female, 64% had concomitant coronary disease, and the median duration of HF was 2.7 years (0.6, 6.8). The median baseline LVEF was 30% (23, 35) and 1032 (49%) patients had a > 5% improvement in LVEF over time. Patients that had an improvement in LVEF over time had a significant simultaneous improvement in KCCQ-12 overall summary score compared with patients with no improvement (change from baseline: +6.8 vs +3.0, adjusted effect estimate 3.8 [95% CI 1.8 to 5.7]) ( Table ). Similarly, subsequent HF hospitalization or all-cause death occurred in 14% in the LVEF improvement group vs 27% in the no LVEF improvement group (adjusted hazard ratio 0.52, 95% CI 0.43 to 0.63). Conclusions: In a large cohort of outpatients with chronic HFrEF, improvements in LVEF were common and associated with improvements in health status and clinical outcomes. These data underscore the importance of changes in LVEF as a treatment target for medical interventions for patients with chronic HFrEF.