Long-term and clinical profile of heart failure with recovered ejection fraction in a non-tertiary hospital

Abstract

IntroductionHeart failure (HF) with recovered ejection fraction (EF) is emerging as a different HF subtype. There is little information about his clinical profile in hospitals that are not a reference. MethodsWe analyzed characteristics and prognosis in patients with recovered HF followed prospectively in the HF Unit of a non-tertiary hospital. ResultsA total of 431 patients with HF with reduced EF were followed (median 50 months, 79.3% males, mean age 70.3±12.2years). Of the patients, 26.9% (N 116) recovered EF, mainly in the first year of follow-up (76.7%). Compared with patients that did not recovered EF in the follow-up, they were younger, rate of ischemic origin of cardiomyopathy was less frequent and presented less comorbidity. Mortality was lower in patients with recovered HF (survival median of 85.2±2.1 vs. 74.2±1.9 months [log-rank χ2 11.5, p=0.001], hazard ratio 0.37, 95% confidence interval [CI]: 0.21–0.67, p=0.002). Etiology of deaths was not mainly secondary to HF. Younger age of 68 years (odds ratio [OR] 0–98, 95% CI: 0.96–0.99; p=0.025), ischemic origin (OR 1.12, 95% CI: 1.01–1.21; p=0.003) and use of aldosterone antagonists (OR 1.89, 95% CI: 1.09–3.26; p=0.023) were the variables independently associated to normalization of EF. ConclusionHF with recovered EF is a frequent phenomenon. It has a more favorable clinical course, prognosis and basal characteristics than HF with persistent reduced EF. Further studies are needed to identify natural history and optimal medications for HF-recovered patients.