Impact of Optimized Heart Failure Management Program on Cardiac Function and Morphometric Remodeling

Background Heart failure (HF) remains a major driver of morbidity, hospitalization, and mortality. Although optimized heart failure management programs (HF-MPs) improve clinical outcomes, their impact on whole-heart structural and functional reverse remodeling remains insufficiently characterized. Methods This retrospective, single-center cohort study evaluated 234 patients with HF, comparing 160 participants in an optimized HF-MP against 74 controls receiving usual care. Clinical status, biomarkers, and comprehensive echocardiographic parameters were assessed at baseline and after a one-year follow-up. Results HF-MP participation was independently associated with highly favorable cardiac functional and morphometric improvements. Left ventricular ejection fraction (LVEF) increased by 6.94 ± 9.07% in the HF-MP group but declined by 4.87 ± 5.56% in controls, while left ventricular global longitudinal strain (LV GLS) improved by − 5.09 ± 5.55% versus a + 3.21 ± 3.45% deterioration in the control arm (both p < 0.001). Divergent, favorable trajectories were also documented for right ventricular fractional area change (RV FAC), right ventricular global longitudinal strain (RV GLS), and left atrial (LA) strain, alongside significant reductions in biatrial volumes and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels (all p < 0.001). These structural improvements coincided with marked functional status recovery, as evidenced by NYHA functional class and 6-minute walk test performance (both p < 0.001). Inter-group differences remained robust after adjustment for age and sex. Conclusions Structured HF-MP care promotes comprehensive biventricular and biatrial reverse remodeling. These findings suggest that evaluating HF-MP efficacy should extend beyond traditional clinical endpoints to encompass objective, multi-chamber structural and functional recovery during follow-up.