Patient‐Reported Health Status Among Patients With Heart Failure With Improved Ejection Fraction

Background The prevalence of heart failure with improved ejection fraction (HFimpEF) is growing. The association of ejection fraction (EF) recovery and changes in health status has not been previously reported. We aimed to characterize patient‐reported health status among patients with HFimpEF, heart failure with reduced ejection fraction, and heart failure with midrange (HFmrEF) or preserved ejection fraction (HFpEF). Methods We identified patients with heart failure with 2 clinic visits, who completed a Kansas City Cardiomyopathy Questionnaire‐12 from August 2020 to October 2023. HFimpEF was defined as most recent EF >40% from a preceding echocardiogram ≥30 days prior with EF ≤40%. We analyzed Kansas City Cardiomyopathy Questionnaire‐12 Overall Summary Score across EF classifications with and without adjustment for patient characteristics via multivariable linear regression. We calculated the R 2 to determine the impact of clinical characteristics on variation in health status among patients with HFimpEF. Results A total of 2519 patients were included, of which 18.7% had HFimpEF, 55.7% had HFmrEF/HFpEF, and 25.6% had HFrEF. Patients with HFimpEF were less likely to be women compared with patients with HFmrEF/HFpEF (41% versus 58%, P <0.01). Overall Summary Score was 5.2 points lower among patients with HFrEF versus HFimpEF (95% CI, −8.2 to −2.3); P =0.010) but patients with HFimpEF had similar scores as HFmrEF/HFpEF (−1.1 95% CI, −3.7 to 1.6; P =0.43). A multivariable regression model explained 16% of the variation in the Overall Summary Score in the HFimpEF subgroup. Conclusions Despite improvement in EF, patients with HFimpEF continue to have impaired health status similar to HFpEF. Further research is needed to understand and improve health status among patients with HFimpEF.