Key result
Specialized HF clinic management linked to improved LVEF in ~40% of patients.
Why the study?
Managing heart failure in resource-limited settings presents significant challenges, with limited data on quality of life and functional outcomes.
Observational (n=454)
No
In a specialized heart failure clinic in a resource-limited setting, nearly 40% of patients experienced LVEF improvement, which was more likely in females and those with baseline HFrEF.
May support specialized HF clinics for LVEF recovery in resource-limited settings; hypothesis-generating and requires randomized confirmation.
BACKGROUND: Managing heart failure patients in resource-limited settings presents significant challenges, with limited data on quality of life and functional outcomes. This study investigated these outcomes in patients attending a heart failure clinic (HFC) in Dhaka, Bangladesh. METHODS: Data were analyzed from 454 patients registered between January 2016 and December 2021 at the HFC of the United Hospital Limited, Dhaka, Bangladesh, who had baseline and follow-up data, including left ventricular ejection fraction (LVEF). A multivariable logistic regression model using generalized estimating equations identified predictors of ≥5% LVEF improvement. RESULTS: Patients averaged 58.4 ± 11.4 years, with 80.4% being male. Median baseline LVEF was 35% (IQR: 30-40). At baseline, 77.3% had heart failure with reduced ejection fraction (HFrEF), 10.1% had heart failure with mid-range ejection fraction (HFmrEF), and 12.6% had heart failure with preserved ejection fraction (HFpEF). LVEF improved in 39.6% of patients, while quality of life improved in 16.1%. Significant predictors of ≥5% LVEF improvement included age (adjusted odds ratio (aOR): 0.97; 95% CI: 0.95-0.99), female sex (aOR: 2.13; 95% CI: 1.21-3.73), history of acute kidney injury (aOR: 0.12; 95% CI: 0.02-0.81), and baseline HFrEF (aOR: 2.90; 95% CI: 1.34-6.26). CONCLUSION: These findings underscore the need for tailored heart failure management approaches in resource-limited settings that consider patient-specific factors alongside dedicated interventions to improve quality of life.
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Momenuzzaman et al. (2025) conducted an observational in Heart failure (n=454). Specialized heart failure clinic management vs. Baseline was evaluated on ≥5% improvement in left ventricular ejection fraction (LVEF). Management at a specialized heart failure clinic was associated with a ≥5% improvement in left ventricular ejection fraction in 39.6% of patients over a median follow-up of 22 months.
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