Heart Failure with Recovered Left Ventricular Ejection Fraction
Keywords:
heart failure with recovered left ventricular ejection fraction, heart failure with reduced left ventricular ejection fraction, peripartum cardiomyopathyAbstract
Heart failure with recovered left ventricular ejection fraction (HFrecEF) is defined as heart failure previously documented that LV ejection fraction (LVEF) was less than 40% and subsequent follow-up study after treatment showed more than 10% improvement of LVEF and greater than 40%. The recovery of LVEF depends on the ethiology of LV systolic dysfunction that causes heart failure with reduced LV ejection fraction (HFrEF) and also the treatment of heart failure. Heart failure with less severity or full recovery of myocardial pathology has better recovery of LVEF such as in tachycardia induced cardiomyopathy, Takotsubo cardiomyopathy, and hyperthyroidism. However, the recovery of LVEF reflects adaptation to the new balance of myocardial function rather than fully remission of pathology of the disease. The recommendation for treatment of HFrecEF is still based on the treatment guideline for HFrEF, even in patient with normal functional capacity and normal LVEF. Termination of HFrecEF treatments may be considered in patient with completely correctable causes of heart failure such as peripartum cardiomyopathy with normal LVEF.
References
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2. Buddeke J, Valstar GB, van Dis I, et al. Mortality after hospital admission for heart failure: improvement over time, equally strong in women as in men. BMC Public Health. 2020; 20(1): 36.
3. Burnett H, Earley A, Voors AA, et al. Thirty Years of Evidence on the Efficacy of Drug Treatments for Chronic Heart Failure With Reduced Ejection Fraction: A Network Meta-Analysis. Circ Heart Fail. 2017; 10(1 :e003529. doi: 10.1161/CIRCHEARTFAILURE.116.003529.
4. Francis GS, Johnson TH, Ziesche S, et al. Marked spontaneous improvement in ejection fraction in patients with congestive heart failure. Am J Med. 1990; 89(3): 303-7. doi: 10.1016/0002-9343(90)90342-b.
5. van Campen LC, Visser FC, Visser CA. Ejection fraction improvement by beta-blocker treatment in patients with heart failure: an analysis of studies published in the literature. J Cardiovasc Pharmacol. 1998; 32 Suppl 1: S31-5. doi: 10.1097/00005344-199800003-00006.
6. Packer M, Antonopoulos GV, Berlin JA, et al. Comparative effects of carvedilol and metoprolol on left ventricular ejection fraction in heart failure: results of a meta-analysis. Am Heart J. 2001; 141(6): 899-907. doi: 10.1067/mhj.2001.115584.
7. Dunlay SM, Roger VL, Weston SA, et al. Longitudinal changes in ejection fraction in heart failure patients with preserved and reduced ejection fraction. Circ Heart Fail. 2012; 5(6): 720-6. doi: 10.1161/CIRCHEARTFAILURE.111.966366.
8. Basuray A, French B, Ky B, et al. Heart failure with recovered ejection fraction: clinical description, biomarkers, and outcomes. Circulation. 2014; 129(23): 2380-7. doi: 10.1161/CIRCULATIONAHA.113.006855.
9. Wilcox JE, Fang JC, Margulies KB, et al. Heart Failure With Recovered Left Ventricular Ejection Fraction: JACC Scientific Expert Panel. J Am Coll Cardiol. 2020; 76(6): 719-34. doi: 10.1016/j.jacc.2020.05.075.
10. Punnoose LR, Givertz MM, Lewis EF, et al. Heart failure with recovered ejection fraction: a distinct clinical entity. J Card Fail. 2011; 17(7): 527-32. doi: 10.1016/j.cardfail.2011.03.005.
11. Gulati G, Udelson JE. Heart Failure With Improved Ejection Fraction: Is it Possible to Escape One's Past? JACC Heart Fail. 2018; 6(9): 725-33. doi: 10.1016/j.jchf.2018.05.004
12. Florea VG, Rector TS, Anand IS, et al. Heart Failure With Improved Ejection Fraction: Clinical Characteristics, Correlates of Recovery, and Survival: Results From the Valsartan Heart Failure Trial. Circ Heart Fail. 2016;9(7) :e003123. doi: 10.1161/CIRCHEARTFAILURE.116.003123.
13. Givertz MM, Mann DL. Epidemiology and natural history of recovery of left ventricular function in recent onset dilated cardiomyopathies. Curr Heart Fail Rep. 2013; 10(4): 321-30. doi: 10.1007/s11897-013-0157-5.
14. Wilcox JE, Mann DL. Beta-blockers for the treatment of heart failure with a mid-range ejection fraction: deja-vu all over again? Eur Heart J. 2018; 39(1): 36-8. doi: 10.1093/eurheartj/ehx663.
15. Wilcox JE, Fonarow GC, Yancy CW, et al. Factors associated with improvement in ejection fraction in clinical practice among patients with heart failure: findings from IMPROVE HF. Am Heart J. 2012; 163(1): 49-56 e2. doi: 10.1016/j.ahj.2011.10.001.
16. Mann DL, Barger PM, Burkhoff D. Myocardial recovery and the failing heart: myth, magic, or molecular target? J Am Coll Cardiol. 2012;60(24):2465-72. doi: 10.1016/j.jacc.2012.06.062.
17. Kim GH, Uriel N, Burkhoff D. Reverse remodelling and myocardial recovery in heart failure. Nat Rev Cardiol. 2018; 15(2): 83-96. doi: 10.1038/nrcardio.2017.139.
18. Reiken S, Wehrens XH, Vest JA, et al. Beta-blockers restore calcium release channel function and improve cardiac muscle performance in human heart failure. Circulation. 2003; 107(19): 2459-66. doi: 10.1161/01.CIR.0000068316.53218.49.
19. Sipahi I, Chou JC, Hyden M, et al. Effect of QRS morphology on clinical event reduction with cardiac resynchronization therapy: meta-analysis of randomized controlled trials. Am Heart J. 2012; 163(2): 260-7 e3. doi: 10.1016/j.ahj.2011.11.014.
20. Halliday BP, Wassall R, Lota AS, et al. Withdrawal of pharmacological treatment for heart failure in patients with recovered dilated cardiomyopathy (TRED-HF): an open-label, pilot, randomised trial. Lancet. 2019; 393(10166): 61-73. doi: 10.1016/S0140-6736(18)32484-X.
21. Hopper I, Samuel R, Hayward C, et al. Can medications be safely withdrawn in patients with stable chronic heart failure? systematic review and meta-analysis. J Card Fail. 2014; 20(7): 522-32. doi: 10.1016/j.cardfail.2014.04.013.
22. The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial. Lancet. 1999; 353(9146): 9-13.
23. Colucci WS, Kolias TJ, Adams KF, et al. Metoprolol reverses left ventricular remodeling in patients with asymptomatic systolic dysfunction: the REversal of VEntricular Remodeling with Toprol-XL (REVERT) trial. Circulation. 2007; 116(1): 49-56. doi: 10.1161/CIRCULATIONAHA.106.666016.
24. Januzzi JL, Jr., Prescott MF, Butler J, et al. Association of Change in N-Terminal Pro-B-Type Natriuretic Peptide Following Initiation of Sacubitril-Valsartan Treatment With Cardiac Structure and Function in Patients With Heart Failure With Reduced Ejection Fraction. JAMA. 2019; 322(11): 1085-95. doi: 10.1001/jama.2019.12821.
25. Investigators S, Yusuf S, Pitt B, et al. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med. 1992; 327(10): 685-91. doi: 10.1056/NEJM199209033271003.
26. Solomon SD, Skali H, Anavekar NS, et al. Changes in ventricular size and function in patients treated with valsartan, captopril, or both after myocardial infarction. Circulation. 2005; 111(25): 3411-9. doi: 10.1161/CIRCULATIONAHA.104.508093.
27. Amos AM, Jaber WA, Russell SD. Improved outcomes in peripartum cardiomyopathy with contemporary. Am Heart J. 2006; 152(3): 509-13. doi: 10.1016/j.ahj.2006.02.008.
28. Bristow MR, Gilbert EM, Abraham WT, et al. Carvedilol produces dose-related improvements in left ventricular function and survival in subjects with chronic heart failure. MOCHA Investigators. Circulation. 1996; 94(11): 2807-16. doi: 10.1161/01.cir.94.11.2807.
29. Aimo A, Gaggin HK, Barison A, et al. Imaging, Biomarker, and Clinical Predictors of Cardiac Remodeling in Heart Failure With Reduced Ejection Fraction. JACC Heart Fail. 2019; 7(9): 782-94. doi: 10.1016/j.jchf.2019.06.004.
30. Swat SA, Cohen D, Shah SJ, et al. Baseline Longitudinal Strain Predicts Recovery of Left Ventricular Ejection Fraction in Hospitalized Patients With Nonischemic Cardiomyopathy. J Am Heart Assoc. 2018; 7(20): e09841. doi: 10.1161/JAHA.118.009841.
2. Buddeke J, Valstar GB, van Dis I, et al. Mortality after hospital admission for heart failure: improvement over time, equally strong in women as in men. BMC Public Health. 2020; 20(1): 36.
3. Burnett H, Earley A, Voors AA, et al. Thirty Years of Evidence on the Efficacy of Drug Treatments for Chronic Heart Failure With Reduced Ejection Fraction: A Network Meta-Analysis. Circ Heart Fail. 2017; 10(1 :e003529. doi: 10.1161/CIRCHEARTFAILURE.116.003529.
4. Francis GS, Johnson TH, Ziesche S, et al. Marked spontaneous improvement in ejection fraction in patients with congestive heart failure. Am J Med. 1990; 89(3): 303-7. doi: 10.1016/0002-9343(90)90342-b.
5. van Campen LC, Visser FC, Visser CA. Ejection fraction improvement by beta-blocker treatment in patients with heart failure: an analysis of studies published in the literature. J Cardiovasc Pharmacol. 1998; 32 Suppl 1: S31-5. doi: 10.1097/00005344-199800003-00006.
6. Packer M, Antonopoulos GV, Berlin JA, et al. Comparative effects of carvedilol and metoprolol on left ventricular ejection fraction in heart failure: results of a meta-analysis. Am Heart J. 2001; 141(6): 899-907. doi: 10.1067/mhj.2001.115584.
7. Dunlay SM, Roger VL, Weston SA, et al. Longitudinal changes in ejection fraction in heart failure patients with preserved and reduced ejection fraction. Circ Heart Fail. 2012; 5(6): 720-6. doi: 10.1161/CIRCHEARTFAILURE.111.966366.
8. Basuray A, French B, Ky B, et al. Heart failure with recovered ejection fraction: clinical description, biomarkers, and outcomes. Circulation. 2014; 129(23): 2380-7. doi: 10.1161/CIRCULATIONAHA.113.006855.
9. Wilcox JE, Fang JC, Margulies KB, et al. Heart Failure With Recovered Left Ventricular Ejection Fraction: JACC Scientific Expert Panel. J Am Coll Cardiol. 2020; 76(6): 719-34. doi: 10.1016/j.jacc.2020.05.075.
10. Punnoose LR, Givertz MM, Lewis EF, et al. Heart failure with recovered ejection fraction: a distinct clinical entity. J Card Fail. 2011; 17(7): 527-32. doi: 10.1016/j.cardfail.2011.03.005.
11. Gulati G, Udelson JE. Heart Failure With Improved Ejection Fraction: Is it Possible to Escape One's Past? JACC Heart Fail. 2018; 6(9): 725-33. doi: 10.1016/j.jchf.2018.05.004
12. Florea VG, Rector TS, Anand IS, et al. Heart Failure With Improved Ejection Fraction: Clinical Characteristics, Correlates of Recovery, and Survival: Results From the Valsartan Heart Failure Trial. Circ Heart Fail. 2016;9(7) :e003123. doi: 10.1161/CIRCHEARTFAILURE.116.003123.
13. Givertz MM, Mann DL. Epidemiology and natural history of recovery of left ventricular function in recent onset dilated cardiomyopathies. Curr Heart Fail Rep. 2013; 10(4): 321-30. doi: 10.1007/s11897-013-0157-5.
14. Wilcox JE, Mann DL. Beta-blockers for the treatment of heart failure with a mid-range ejection fraction: deja-vu all over again? Eur Heart J. 2018; 39(1): 36-8. doi: 10.1093/eurheartj/ehx663.
15. Wilcox JE, Fonarow GC, Yancy CW, et al. Factors associated with improvement in ejection fraction in clinical practice among patients with heart failure: findings from IMPROVE HF. Am Heart J. 2012; 163(1): 49-56 e2. doi: 10.1016/j.ahj.2011.10.001.
16. Mann DL, Barger PM, Burkhoff D. Myocardial recovery and the failing heart: myth, magic, or molecular target? J Am Coll Cardiol. 2012;60(24):2465-72. doi: 10.1016/j.jacc.2012.06.062.
17. Kim GH, Uriel N, Burkhoff D. Reverse remodelling and myocardial recovery in heart failure. Nat Rev Cardiol. 2018; 15(2): 83-96. doi: 10.1038/nrcardio.2017.139.
18. Reiken S, Wehrens XH, Vest JA, et al. Beta-blockers restore calcium release channel function and improve cardiac muscle performance in human heart failure. Circulation. 2003; 107(19): 2459-66. doi: 10.1161/01.CIR.0000068316.53218.49.
19. Sipahi I, Chou JC, Hyden M, et al. Effect of QRS morphology on clinical event reduction with cardiac resynchronization therapy: meta-analysis of randomized controlled trials. Am Heart J. 2012; 163(2): 260-7 e3. doi: 10.1016/j.ahj.2011.11.014.
20. Halliday BP, Wassall R, Lota AS, et al. Withdrawal of pharmacological treatment for heart failure in patients with recovered dilated cardiomyopathy (TRED-HF): an open-label, pilot, randomised trial. Lancet. 2019; 393(10166): 61-73. doi: 10.1016/S0140-6736(18)32484-X.
21. Hopper I, Samuel R, Hayward C, et al. Can medications be safely withdrawn in patients with stable chronic heart failure? systematic review and meta-analysis. J Card Fail. 2014; 20(7): 522-32. doi: 10.1016/j.cardfail.2014.04.013.
22. The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial. Lancet. 1999; 353(9146): 9-13.
23. Colucci WS, Kolias TJ, Adams KF, et al. Metoprolol reverses left ventricular remodeling in patients with asymptomatic systolic dysfunction: the REversal of VEntricular Remodeling with Toprol-XL (REVERT) trial. Circulation. 2007; 116(1): 49-56. doi: 10.1161/CIRCULATIONAHA.106.666016.
24. Januzzi JL, Jr., Prescott MF, Butler J, et al. Association of Change in N-Terminal Pro-B-Type Natriuretic Peptide Following Initiation of Sacubitril-Valsartan Treatment With Cardiac Structure and Function in Patients With Heart Failure With Reduced Ejection Fraction. JAMA. 2019; 322(11): 1085-95. doi: 10.1001/jama.2019.12821.
25. Investigators S, Yusuf S, Pitt B, et al. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med. 1992; 327(10): 685-91. doi: 10.1056/NEJM199209033271003.
26. Solomon SD, Skali H, Anavekar NS, et al. Changes in ventricular size and function in patients treated with valsartan, captopril, or both after myocardial infarction. Circulation. 2005; 111(25): 3411-9. doi: 10.1161/CIRCULATIONAHA.104.508093.
27. Amos AM, Jaber WA, Russell SD. Improved outcomes in peripartum cardiomyopathy with contemporary. Am Heart J. 2006; 152(3): 509-13. doi: 10.1016/j.ahj.2006.02.008.
28. Bristow MR, Gilbert EM, Abraham WT, et al. Carvedilol produces dose-related improvements in left ventricular function and survival in subjects with chronic heart failure. MOCHA Investigators. Circulation. 1996; 94(11): 2807-16. doi: 10.1161/01.cir.94.11.2807.
29. Aimo A, Gaggin HK, Barison A, et al. Imaging, Biomarker, and Clinical Predictors of Cardiac Remodeling in Heart Failure With Reduced Ejection Fraction. JACC Heart Fail. 2019; 7(9): 782-94. doi: 10.1016/j.jchf.2019.06.004.
30. Swat SA, Cohen D, Shah SJ, et al. Baseline Longitudinal Strain Predicts Recovery of Left Ventricular Ejection Fraction in Hospitalized Patients With Nonischemic Cardiomyopathy. J Am Heart Assoc. 2018; 7(20): e09841. doi: 10.1161/JAHA.118.009841.
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2021-06-29
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Mateesiriwat W. Heart Failure with Recovered Left Ventricular Ejection Fraction. Reg 4-5 Med J [internet]. 2021 Jun. 29 [cited 2025 Dec. 8];40(2). available from: https://he02.tci-thaijo.org/index.php/reg45/article/view/251838
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ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
