Prognostic Value of Baseline Echocardiographic Parameters in Heart Failure with Improved Versus Non-Recovered Ejection Fraction

BackgroundEjection fraction is often used as a prognostic indicator and for classifying heart failure patients. This study evaluates the association of echocardiographic parameters with heart failure with improved ejection fraction (HFimpEF).MethodsThis single-center study retrospectively included heart failure with reduced ejection fraction (HFrEF) patients from a cohort of admitted patients over 2018-2020, which were then followed up prospectively until 2023. The control group was categorized as non-recovered HFrEF and the population group was categorized as HFimpEF.ResultsA total of 176 patients with HFrEF were included in the study. Non-ischemic etiology was found to be the most prevalent cause of HFimpEF. The baseline echocardiography examination revealed that the HFimpEF group exhibited significantly higher values for tricuspid annular plane systolic excursion (TAPSE) (P < 0.001) and inferior vena cava (IVC) diameter (P < 0.001). On the other hand, the non-recovered HFrEF group demonstrated higher baseline left atrial volume index (LAVi) values (P < 0.001). In multivariate analysis, higher value of TAPSE (OR 3.071; P = 0.008) and lower value of LAVi (OR 2.034; P = 0.008) were independent echocardiography variables associated with HFimpEF. After a mean follow-up duration of 32.5 ± 9.1 months, the HFimpEF group had higher survival from re-hospitalization due to worsening HF and lower all-cause mortality (Log Rank P < 0.001 and P = 0.005, respectively).ConclusionsBaseline echocardiographic parameters of higher TAPSE and lower LAVi were associated with the transition from HFrEF to HFimpEF. The HFimpEF group had better survival compared to non-recovered HFrEF.