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A. Basics
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
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30. Cardiovascular Disease in Special Populations
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32. Cardiovascular Nursing
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Predictors of heart failure with improved ejection fraction: insights from a real-world study
Session:
Sessão de Posters 49 - Insuficiência cardíaca para além da fração de ejeção do VE melhorada e recuperada: padrões de recuperação, preditores e marcadores de risco
Speaker:
Mauro Moreira
Congress:
CPC 2026
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.2 Chronic Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Mauro Moreira; José Luís Ferraro; Inês Bastos Castro; Inês Gomes Campos; Ana Rodrigo Costa; Joel Ponte Monteiro; Inês Almeida; Ana Leal Neto; Adriana Pereira; Patrícia Silva; Aurora Andrade
Abstract
<p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Introduction: </span></strong><span style="font-family:"Arial",sans-serif">Heart failure with improved ejection fraction (HFimpEF) is increasingly recognized as a meaningful phenotype. The factors associated with this improvement warrants further investigation.</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Methods: </span></strong><span style="font-family:"Arial",sans-serif">Single-center retrospective study with consecutive patients with chronic heart failure with reduced ejection fraction (HFrEF) from an HF clinic between 2014-2024. Previous diseases, medication, clinical status, biomarkers, electrocardiogram and echocardiogram findings were recorded. HFimpEF (left ventricle ejection fraction ≥40% with improvement of ≥10% from baseline) was the endpoint at 1-year post-admission. Backwards Wald logistic regression was used to estimate independent predictor factors of HFimpEF.</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Results: </span></strong><span style="font-family:"Arial",sans-serif">We included 292 patients (73.3% male; mean age 59.9±11.8 years-old), ischemic etiology in 35.3%, median LVEF of 25.0±10.2%. HFimpEF occurred in 24.0% of patients.</span><span style="font-family:"Arial",sans-serif"> It was more prevalent in current smokers (25.7% vs 11.7%; p=0.013); AF (35.7% vs 20.0%; p<0.001); absence of coronary artery disease (CAD) (85.7% vs 49.4%; p<0.001); non-ischemic etiology (88.6% vs 58.3%; p<0.001); shorter QRS (117.9ms vs 131.0ms; p=0.002), absence of late gadolinium enhancement (LGE) (53.3% vs 33.8%; p=0.028), and in patients on sodium-glucose cotransporter 2 inhibitors (SGLT2i) at baseline (62.9% vs 46.1%; p=0.017). After applying these variables in logistic regression, the resulting module has a very good prediction accuracy for HFimpEF (AUC=0.835). Previous CAD (OR=0.06; p=0.013), LGE with ischemic pattern (OR=0.196; p=0.035) and QRS duration (OR=0.98; p=0.026) were identified as independent predictors of the endpoint. Paradoxically, smoking was the strongest predictor of HFimpEF (OR=39.1; p<0.001).</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Conclusion: </span></strong><span style="font-family:"Arial",sans-serif">This study highlights the role of previous CAD and LGE with ischemic pattern in predicting HFimpEF, regardless of HF etiology, as well as QRS duration. Unexpectedly, HFrEF therapy did not predict HFimpEF. The relationship between smoking and HFimpEF needs further investigation.</span></span></span></p>
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