Predictors of Medical Therapy-Induced LV Improvement in HFrEF, with Viet Le PA-C

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A retrospective analysis of real-world data from adult patients with heart failure with reduced ejection fraction (HFrEF) is providing practicing clinicians with perspective on clinical predictors of medical therapy-induced improvement in left ventricular function among these patients.

Presented at the American Heart Association 2022 Scientific Sessions, results of the Intermountain Healthcare-led study indicate a low initial BNP, female gender, no history of myocardial infarction, and absence of atherosclerotic cardiovascular disease were the strongest predictors of left ventricular ejection fraction (LVEF) improvement among a cohort of more than 5000 patients with a median follow-up of 6.2 years.

Launched with an interest in further developing the knowledge base related to management of HFrEF, a team from Intermountain Healthcare designed a retrospective analysis leveraging electronic medical record data from adult patients treated within 24 hospitals and more than 200 clinics affiliated with Intermountain Healthcare. Limiting their search to those with a baseline LVEF of 35% or less and at least 180 days of with no follow-up transplant, investigators identified 5362 individuals for inclusion in their analysis.

For the purpose of analysis, these patients were categorized according to change in LVEF observed from baseline and follow-up. These groups were defined as an improvement of 10% or greater, a change of -9% to +9%, and a reduction of 10% or greater, with 3074, 2193, and 365 patients, respectively, falling into each of these categories.

Results of the investigators’ analyses demonstrated increased LVEF was associated with a lower death rate and the identified predictors for increased LVEF were female gender, the absence of ASCVD, a low initial BNP, a narrow QRS duration, and the presence of atrial fibrillation, pulmonary hypertension, and statin use. To learn more about the study and the clinical implications of the results, our editorial team sat down with study investigator Viet Le, PA-C, while on-site at AHA 2022.