SPC365

Predictors of improvement in ejection fraction in patients with newly diagnosed heart failure with reduced ejection fraction

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: Francisco Rodrigues Dos Santos

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: Francisco Rodrigues dos Santos; Mariana Duarte Almeida; Gonçalo Ferreira; João Gouveia Fiúza; Oliver Correia Kungel; Luís Afonso Santos; António Costa; Inês Fiúza Pires

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Introduction:</span></span></strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"> Patients with heart failure with reduced ejection fraction (HFrEF) have heterogeneous prognosis, and while some have persistently reduced left ventricular ejection fraction (LVEF), others have improvement in ejection fraction (HFimpEF). HFimpEF includes patients with a baseline LVEF&le;40%, that have a &ge;10 percentage points increase from baseline LVEF and a second measurement of LVEF&gt;40%. The aim of this study is to identify predictors of HFimprEF, in patients newly diagnosed with HFrEF.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Methods:</span></span></strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"> This retrospective, single-center study included all patients referred to Cardiology consultation due to recently diagnosed HFrEF. Follow up was at least one year. Demographic variables, comorbidities, etiology, medical therapy, blood analysis, electrocardiogram and echocardiogram were analyzed. Statistical analysis used chi-square, Mann-Whitney U tests and binary logistic regressions.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Results:</span></span></strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"> 89 patients were studied: 64 (71.9%) had HFimpEF; 21(23.6%) had persistent HFrEF; 4 (4.5%) had improvement in LVEF that didn&rsquo;t fulfil criteria for HFimpEF. 69.4% of patients were male; mean age was 63&plusmn;12 years old; mean LVEF was 30.3&plusmn;5.4%. HFimpEF was associated with non-ischemic etiology (p=0.09), history of excessive alcoholic ingestion (p=0.019), lower frequency of chronic kidney disease (p=0.05), non-dilated LV (p=0.016), higher prescription of betablockers during follow-up (p=0.03), absence of transmural late gadolinium enhancement in cardiac magnetic resonance (p=0.012), lower NTproBNP levels (p=0.038). There were no differences between HFimpEF and persistent HFrEF regarding age, sex, QRS duration or other medical therapy, namely </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">RAAS inhibitors and SGLT2 receptor&ndash;targeting drugs</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">. During follow-up, HFimpEF was associated with fewer HF hospitalizations (p=0.013). Univariate logistic regression analysis showed that history of excessive alcoholic ingestion (OR 3.627; 95% CI 1.186-11.090; p=0.024), non-ischemic etiology (OR 4.308; 95% CI 1.363-13.616; p=0.013), lower LV telediastolic volume (OR 0.977; 95% CI 0.955-0.999; p=0.045) and prescription of betablockers during follow-up (OR 9.687; 95% CI 1.718-54.615; p=0.010) were predictors of HFimpEF. In multivariate analysis, only history of excessive alcoholic ingestion (OR 26.244; p=0.043), non-ischemic etiology (OR 21.826; p=0.036) and lower LV telediastolic volume (OR 0.971; p=0.05) were independent predictors of HFimpEF.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Discussion/conclusion:</span></span></strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"> In patients with newly diagnosed HFrEF, 71.9% fulfilled criteria for HFimpEF during follow-up. Patients with HFimpEF had fewer HF hospitalizations. The only independent predictors of HFimpEF were history of excessive alcoholic ingestion, non-ischemic etiology and lower LV telediastolic volume. This might allow better risk stratification and prognostic evaluation in patients recently diagnosed with HFrEF.</span></span></span></span></p>