Key result
Higher baseline TAPSE (OR 3.071, P=0.008) and lower LAVi (OR 2.034, P=0.008) were independently associated with transition to HFimpEF, which had lower all-cause mortality (P=0.005).
Why the study?
Ejection fraction is commonly used for prognosis and classification in heart failure, but the association of echocardiographic parameters with heart failure with improved ejection fraction (HFimpEF) requires evaluation.
Are baseline echocardiographic parameters associated with the transition from HFrEF to HFimpEF?
Cohort (n=176)
No
Are baseline echocardiographic parameters associated with the transition from HFrEF to HFimpEF?
Baseline echocardiographic parameters, specifically higher TAPSE and lower LAVi, can predict the transition from HFrEF to HFimpEF, which is associated with improved survival and reduced re-hospitalization.
Baseline echo parameters may identify HFrEF patients prone to improvement; leaves open whether they should guide therapy.
Background Ejection fraction is often used as a prognostic indicator and for classifying heart failure patients. This study evaluates the association of echocardiographic parameters with heart failure with improved ejection fraction (HFimpEF). Methods This single-center study retrospectively included heart failure with reduced ejection fraction (HFrEF) patients from a cohort of admitted patients over 2018-2020, which were then followed up prospectively until 2023. The control group was categorized as non-recovered HFrEF and the population group was categorized as HFimpEF. Results A total of 176 patients with HFrEF were included in the study. Non-ischemic etiology was found to be the most prevalent cause of HFimpEF. The baseline echocardiography examination revealed that the HFimpEF group exhibited significantly higher values for tricuspid annular plane systolic excursion (TAPSE) (P < 0.001) and inferior vena cava (IVC) diameter (P < 0.001). On the other hand, the non-recovered HFrEF group demonstrated higher baseline left atrial volume index (LAVi) values (P < 0.001). In multivariate analysis, higher value of TAPSE (OR 3.071; P=0.008) and lower value of LAVi (OR 2.034; P=0.008) were independent echocardiography variables associated with HFimpEF. After a mean follow-up duration of 32.5 ± 9.1 months, the HFimpEF group had higher survival from re-hospitalization due to worsening HF and lower all-cause mortality (Log Rank P < 0.001 and P=0.005, respectively). Conclusions Baseline echocardiographic parameters of higher TAPSE and lower LAVi were associated with the transition from HFrEF to HFimpEF. The HFimpEF group had better survival compared to non-recovered HFrEF.
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Jagannatha et al. (2023) conducted a cohort in Heart failure with reduced ejection fraction (HFrEF) (n=176). Higher TAPSE and lower LAVi vs. Lower TAPSE and higher LAVi was evaluated on Heart failure with improved ejection fraction (HFimpEF) (OR 3.071, p=0.008). Higher baseline TAPSE (OR 3.071, P=0.008) and lower LAVi (OR 2.034, P=0.008) were independently associated with transition to HFimpEF, which had lower all-cause mortality (P=0.005).
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