Long-Term Outcomes and Risk Stratification of Patients With Heart Failure With Recovered Ejection Fraction

Perry, Andrew; Mudigonda, Parvathi; Huang, Gary; Qureshi, Binish G.; Cheng, Richard K.; Levy, Wayne C.; Li, Song

doi:10.1016/j.amjcard.2022.03.006

Cited by 7 publications

(10 citation statements)

References 17 publications

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“…Studies on HFpEF and/or HFmrEF patients reported real-world treatment patterns as percentages for different therapies [ 13 , 36 – 40 , 43 , 44 , 46 , 47 , 49 , 50 , 60 , 62 , 63 , 65 , 68 , 69 , 76 , 77 , 90 – 92 , 100 , 111 ]. Commonly used medications included beta-blockers, renin-angiotensin system inhibitors (RASIs), diuretics (loop or thiazide), ACE-Is/ARBs (in combination or separately), anti-coagulants, and calcium channel blockers, as well as statins and MRAs.…”

Section: Resultsmentioning

confidence: 99%

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Heart failure with mildly reduced and preserved ejection fraction: A review of disease burden and remaining unmet medical needs within a new treatment landscape

Desai,

Olewinska,

Famulska

et al. 2024

Heart Fail Rev

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This review provides a comprehensive overview of heart failure with mildly reduced and preserved ejection fraction (HFmrEF/HFpEF), including its definition, diagnosis, and epidemiology; clinical, humanistic, and economic burdens; current pharmacologic landscape in key pharmaceutical markets; and unmet needs to identify key knowledge gaps. We conducted a targeted literature review in electronic databases and prioritized articles with valuable insights into HFmrEF/HFpEF. Overall, 27 randomized controlled trials (RCTs), 66 real-world evidence studies, 18 clinical practice guidelines, and 25 additional publications were included. Although recent heart failure (HF) guidelines set left ventricular ejection fraction thresholds to differentiate categories, characterization and diagnosis criteria vary because of the incomplete disease understanding. Recent epidemiological data are limited and diverse. Approximately 50% of symptomatic HF patients have HFpEF, more common than HFmrEF. Prevalence varies with country because of differing definitions and study characteristics, making prevalence interpretation challenging. HFmrEF/HFpEF has considerable mortality risk, and the mortality rate varies with study and patient characteristics and treatments. HFmrEF/HFpEF is associated with considerable morbidity, poor patient outcomes, and common comorbidities. Patients require frequent hospitalizations; therefore, early intervention is crucial to prevent disease burden. Recent RCTs show promising results like risk reduction of composite cardiovascular death or HF hospitalization. Costs data are scarce, but the economic burden is increasing. Despite new drugs, unmet medical needs requiring new treatments remain. Thus, HFmrEF/HFpEF is a growing global healthcare concern. With improving yet incomplete understanding of this disease and its promising treatments, further research is required for better patient outcomes.

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Section: Resultsmentioning

confidence: 99%

“…SGLT-2i use in real-life has rarely been reported. No significant differences in treatment patterns were found among patients with HFpEF and HFmrEF [ 13 , 36 – 40 , 43 , 44 , 46 , 47 , 49 , 50 , 60 , 62 , 63 , 65 , 68 , 69 , 76 , 77 , 90 – 92 , 100 , 111 ].…”

Section: Resultsmentioning

confidence: 99%

Heart failure with mildly reduced and preserved ejection fraction: A review of disease burden and remaining unmet medical needs within a new treatment landscape

Desai,

Olewinska,

Famulska

et al. 2024

Heart Fail Rev

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show abstract

“…These characteristics are consistent with previous studies. [4][5][6][7][8][9] Lastly, the persistent group exhibited worse echocardiogram and BNP profiles, and they were prescribed RASi and β blockers more often. This suggests that these treatments were more frequently prescribed to patients with more severe HF.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with HFimpEF have significantly lower rates of mortality, cardiac hospitalizations, all-cause hospitalizations, and composite events. [4][5][6][7][8][9] Moreover, HFimpEF patients have lower rates of cardiac transplantation, LV assist device implantations, and a significant enhancement in health-related quality of life. 10 However, the underlying mechanisms and factors leading to HFimpEF are not yet fully understood.…”

Section: Introductionmentioning

confidence: 99%

“… 7 Echocardiographic data on HFimpEF patients have highlighted an initial better LV dimensions, and diastolic function compared with patients with persistent HFrEF. 8 , 9 However, the absence of a widespread consensus on the clinical, laboratory, echocardiographic, and therapy factors associated with EF improvement remains a challenge. A better understanding of those factors could help clinicians predict which patients are at risk of persistent HFrEF or HFimpEF.…”

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confidence: 99%

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Clinical, Echocardiographic, and Longitudinal Characteristics Associated With Heart Failure With Improved Ejection Fraction

Romero,

Baltodano,

Rocha

et al. 2024

The American Journal of Cardiology

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Myocardial Recovery and Relapse in Heart Failure With Improved Ejection Fraction

Kodur,

Tang

2024

Curr Treat Options Cardio Med

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Purpose of review The purpose of this review is to discuss myocardial recovery in heart failure with reduced ejection fraction (HFrEF) and to summarize the contemporary insights regarding heart failure with improved ejection fraction (HFimpEF). Recent findings Improvement in left ventricular ejection fraction (LVEF ≥ 40%) with improved prognosis can be achieved in one out of three (10–40%) patients with HFrEF treated with guideline-directed medical therapy. Clinical predictors include non-ischemic etiology of HFrEF, less abnormal blood or imaging biomarkers, and lack of specific pathogenic genetic variants. However, a subset of patients may ultimately relapse, suggesting that many patients are merely in remission rather than having fully recovered. Summary Patients with HFimpEF have improved prognosis but nonetheless remain at risk of relapse and long-term adverse events. Future studies will hopefully chart the natural history of HFimpEF and identify clinical predictors such as blood or novel imaging biomarkers that distinguish subgroups of patients based on differential trajectory and prognosis.

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Long-Term Outcomes and Risk Stratification of Patients With Heart Failure With Recovered Ejection Fraction

Cited by 7 publications

References 17 publications

Heart failure with mildly reduced and preserved ejection fraction: A review of disease burden and remaining unmet medical needs within a new treatment landscape

Heart failure with mildly reduced and preserved ejection fraction: A review of disease burden and remaining unmet medical needs within a new treatment landscape

Clinical, Echocardiographic, and Longitudinal Characteristics Associated With Heart Failure With Improved Ejection Fraction

Myocardial Recovery and Relapse in Heart Failure With Improved Ejection Fraction

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