What does this research mean for the field?

Higher body mass index, smaller left ventricular end-diastolic diameter, and lower neutrophil-to-lymphocyte ratio are independent predictors of left ventricular reverse remodeling in patients with heart failure with reduced ejection fraction. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The aim is to identify predictors of left ventricular reverse remodeling in heart failure patients with reduced ejection fraction.

January 10, 2026Bratislavské lekárske listy/Bratislava medical journal0 citationsOpen Access

Who Recovers? Clinical and Echocardiographic Predictors of Reverse Remodeling in HFrEF

MCM. ChudýNational Institute of Cardiovascular Diseases LKLukáš KučeraNational Institute of Cardiovascular Diseases MDMarcela DankováNational Institute of Cardiovascular Diseases

Key Result

Higher body mass index, smaller left ventricular end-diastolic diameter, and lower neutrophil-to-lymphocyte ratio were independent predictors of left ventricular reverse remodeling in HFrEF patients.

Key Points

The aim is to identify predictors of left ventricular reverse remodeling in heart failure patients with reduced ejection fraction.
Prospective study design evaluating patients with newly diagnosed HFrEF.
Comprehensive clinical, laboratory, and echocardiographic assessments at baseline.
Repeated assessments within 12 months to measure outcomes.
Logistic regression analysis to identify independent predictors.
LVRR was observed in 50% of patients (30 out of 60).
Higher body mass index was linked to improved outcomes.
Smaller left ventricular end-diastolic diameter was a significant predictor.
Lower neutrophil-to-lymphocyte ratio was also identified as a predictor of LVRR.

Structured PICO

Population

60 patients with newly diagnosed HFrEF (LVEF < 40%) and symptoms and/or signs of heart failure lasting less than 16 weeks, mean age 50.0, 78.3% male. Excluded recent acute coronary syndrome (< 60 days) or significant primary valvular disease.

Outcome

Left ventricular reverse remodelling (LVRR), defined as an absolute LVEF increase of ≥ 10% reaching ≥ 40% within 12 monthssurrogate

In patients with newly diagnosed HFrEF, higher BMI, smaller LVEDD, and lower neutrophil-to-lymphocyte ratio independently predict left ventricular reverse remodeling within 12 months.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Introduction Heart failure with improved ejection fraction (HFimpEF) is a recently recognised phenotype of heart failure. The process responsible for the improvement in cardiac function is referred to as left ventricular reverse remodelling (LVRR), which is associated with better clinical outcomes including improved quality of life, fewer heart failure hospitalisations, and lower mortality. The aim of this study si to identify independent predictors of left ventricular reverse remodelling in patients with newly diagnosed heart failure with reduced ejection fraction (HFrEF). Methods This prospective study included patients with HFrEF (LVEF < 40%) and symptoms and/or signs of heart failure lasting less than 16 weeks. Patients underwent a comprehensive baseline evaluation including clinical, laboratory, and echocardiographic assessment, followed by a repeated assessment within 12 months. LVRR was defined as an absolute LVEF increase of ≥ 10% reaching ≥ 40%. Logistic regression was used to identify independent predictors. Results LVRR occurred in 30 out of 60 patients (50%). In multivariate analysis, higher body mass index (BMI), smaller left ventricular end-diastolic diameter (LVEDD), and lower neutrophil-to-lymphocyte ratio (NLR) were identified as independent predictors of LVRR. Conclusion LVRR is observed in a significant proportion of patients with recently diagnosed HFrEF. Higher BMI, lower LVEDD and lower NLR were independent predictors of LVRR in our cohort. Graphical Abstract

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