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November 1, 2025Circulation Heart Failure

Prognostic Value of Natriuretic Peptide Levels in Heart Failure With Recovered Ejection Fraction

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Why the study?

There were no robust clinical markers for assessing prognosis in patients with heart failure with recovered left ventricular ejection fraction.

Does higher NT-proBNP level at the time of LVEF recovery predict LVEF relapse and a composite of HF hospitalization or all-cause death in patients with HF with recovered LVEF?

Population

3935 patients with HF with recovered LVEF and available NT-proBNP data

Comparison

7 different NT-proBNP groups at the time of LVEF recovery

Design

Retrospective cohort study

Key result

Near-normal NT-proBNP levels (125-299 pg/mL) at LVEF recovery were associated with a 46% higher risk of LVEF relapse and an 82% higher risk of HF hospitalization or death compared to normal levels.

Authors

NKNandan KodurPGPaul R. GunsalusAMAlex Milinovich

Discussion

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Member takes

Overview

May support closer surveillance after LVEF recovery; leaves open whether NT-proBNP-guided therapy improves outcomes.

Study Design

Type

Cohort (n=3,935)

Structured PICO

Does higher NT-proBNP level at the time of LVEF recovery predict LVEF relapse and a composite of HF hospitalization or all-cause death in patients with HF with recovered LVEF?

P
Population
3935 patients with heart failure (HF) with recovered LVEF (previous LVEF of ≤40% with subsequent improvement to ≥50%) and available NT-proBNP data at the time of LVEF recovery
I
Intervention
Higher NT-proBNP levels (categorized into 7 groups) measured at the time of LVEF recovery
C
Comparator
Normal NT-proBNP levels (<125 pg/mL)
O
Outcome
LVEF relapse (decrease in LVEF by ≥10% to <50%) and the composite outcome of HF hospitalization or all-cause deathcomposite

Main Result

Effect estimate: 46% higher risk (LVEF relapse) and 82% higher risk (composite)

NT-proBNP measured at the time of LVEF recovery is an independent, dose-dependent predictor of LVEF relapse and adverse clinical outcomes in patients with HF with recovered LVEF.

Cite This Study

Kodur et al. (2025) conducted a cohort in Heart failure with recovered left ventricular ejection fraction (LVEF) (n=3,935). NT-proBNP levels vs. Normal NT-proBNP levels (<125 pg/mL) was evaluated on LVEF relapse (decrease in LVEF by ≥10% to <50%) and a composite of HF hospitalization or all-cause death (46% higher risk (LVEF relapse) and 82% higher risk (composite)). Near-normal NT-proBNP levels (125-299 pg/mL) at LVEF recovery were associated with a 46% higher risk of LVEF relapse and an 82% higher risk of HF hospitalization or death compared to normal levels.

synapsesocial.com/papers/6a178bac5fdf2a7b88aa1f64https://doi.org/10.1161/circheartfailure.125.013386
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