Who Recovers? Clinical and Echocardiographic Predictors of Reverse Remodeling in HFrEF

Abstract Introduction Heart failure with improved ejection fraction (HFimpEF) is a recently recognised phenotype of heart failure. The process responsible for the improvement in cardiac function is referred to as left ventricular reverse remodelling (LVRR), which is associated with better clinical outcomes including improved quality of life, fewer heart failure hospitalisations, and lower mortality. The aim of this study si to identify independent predictors of left ventricular reverse remodelling in patients with newly diagnosed heart failure with reduced ejection fraction (HFrEF). Methods This prospective study included patients with HFrEF (LVEF < 40%) and symptoms and/or signs of heart failure lasting less than 16 weeks. Patients underwent a comprehensive baseline evaluation including clinical, laboratory, and echocardiographic assessment, followed by a repeated assessment within 12 months. LVRR was defined as an absolute LVEF increase of ≥ 10% reaching ≥ 40%. Logistic regression was used to identify independent predictors. Results LVRR occurred in 30 out of 60 patients (50%). In multivariate analysis, higher body mass index (BMI), smaller left ventricular end-diastolic diameter (LVEDD), and lower neutrophil-to-lymphocyte ratio (NLR) were identified as independent predictors of LVRR. Conclusion LVRR is observed in a significant proportion of patients with recently diagnosed HFrEF. Higher BMI, lower LVEDD and lower NLR were independent predictors of LVRR in our cohort. Graphical Abstract