Why the study?
Contemporary real-world trajectories of LVEF changes after an initial TTE diagnosis of HFrEF, and their relationship with patient characteristics, GDMT use, and outcomes, are not well described.
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In a large real-world cohort, over half of HFrEF patients with repeat imaging recovered their LVEF within 12 months, but GDMT use remained low across all trajectory groups, highlighting significant gaps in care.
What is the clinical question being addressed? Heart failure with reduced ejection fraction (HFrEF) is a leading cause of morbidity and mortality, with guideline-directed medical therapy (GDMT) shown to improve left ventricular ejection fraction (LVEF) and clinical outcomes. However, contemporary real-world trajectories of LVEF changes following an initial transthoracic echocardiography (TTE) diagnosis of HFrEF and how these changes relate to patient characteristics, GDMT use, and outcomes are not well described. What is the main finding? Repeat LVEF assessment occurred in only one-third of patients with HFrEF within one year of the initial TTE. Among those with repeat imaging, 23.9% remained in HFrEF, 18.6% improved to heart failure with mid-range ejection fraction (HFmrEF), and 57.5% improved to heart failure with recovered ejection fraction (HFrecEF). Patients transitioning to HFmrEF or HFrecEF were more likely to be female, White, have a higher baseline LVEF, and fewer cardiovascular comorbidities. GDMT use was low across all LVEF transition categories, highlighting significant opportunities to improve heart failure outcomes.
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Do et al. (2025) studied this question.
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