Treatment characteristics and factors associated with heart failure with improved ejection fraction in the heart failure patient management program at Hanoi Heart Hospital

Abstract

Background: Many patients with heart failure (HF) with reduced ejection fraction (HFrEF) have improved or restored left ventricular ejection fraction (LVEF). Within context heart failure with recovered or improved ejection fraction (HFiEF) has been proposed as a new category of HF. Data on clinical characteristics, outcomes, and medical, interventional, surgical, or related factors in patients with heart failure with improved ejection fraction (HFiEF) are scarce. Methods: Descriptive analysis study, the period from May 2021 to November 2022 satisfies the criteria for heart failure with reduced or slightly reduced ejection fraction and is hospitalized for inpatient treatment, discharged from the hospital to participate in the patient management program heart failure for at least 3 months. Results: 488 patients were included in the study, the average age of the improved group and the remaining group were 64.35±13.74 and 64.39±13.55, the proportion of women in the improvement group and the remaining group are 50% and 41.6%. The rate of use of RAS system drugs and beta blockers improved by 96.4% and 89.3%, respectively, higher than the other group’s 86.1% and 74.5%, which is statistically significant. The rate of MRA, SGLT2-i in the improved group and the remaining group was 63.1%; 59.5% and 64.9%; 61.9%. The rate of using 2 drugs including RAS and beta blockers in the improvement group (85.7%) was statistically significantly higher than the other group (67.6%). The area under the ROC curve of admission EF, LVEDVi, LVESVi in predicting improvement was 0.687 (95% CI 0.640-0.730; p< 0.001), respectively; 0.531(95% CI 0.462-0.599; p=0.378); 0.543 (95% CI 0.467-0.611; p=0.211). If only calculated on the total number of patients with EF ≤ 40%, the Kaplan Meier chart of CABG, heart valve surgery and percutaneous coronary intervention predicting improvement in heart failure after 3 months are all statistically significant. Conclusion: The rate of heart failure improved in the program was 17.2%. EF at admission, rate of use of RAS system drugs, beta blockers, rate of use of 2 RAS system drugs and beta blockers, percutaneous coronary intervention, CABG surgery or Heart valve surgery is significant in predicting improved heart failure in the heart failure program at Hanoi Heart Hospital.