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Improvement but no cure of left ventricular systolic dysfunction in treated heart failure patients.

Abstract：

BACKGROUND:Recent advances in pharmacological and pacemaker-based treatments for heart failure (HF) have brought about significant improvements in left ventricular function. AIMS:To identify the proportion of treated systolic HF patients in whom left ventricular systolic function improves and/or returns to normal. METHODS:This was a retrospective analysis of 221 HF patients. Improvement in left ventricular function was defined as an improvement in ejection fraction (LVEF) of > or =10% on echocardiography. Return to normal was defined as an improvement of LVEF to > or =50% and a reduction in left ventricular end diastolic diameter to < or =55 mm. Changes in BNP were also recorded. RESULTS:Improvement in LVEF was observed in 44.3% of patients and return to normal systolic function in 10.9%, only 2.3% had both a return to normal echocardiographic parameters and a BNP<100 pg/ml. A higher percentage of the improved group were on target doses of beta-blockers (p=0.004). Baseline BNP was not a predictor of improvement. There was a trend towards a reduction in HF readmissions in the improved group (p=0.07) but no difference in the risk of death or all-cause readmission. CONCLUSION:While a substantial proportion of treated HF patients have an improvement in left ventricular function over time, only a small proportion return to normal dimensions and LVEF, underlining the permanent nature of ventricular damage in the vast majority of patients.

journal_name

Eur J Heart Fail

journal_title

European journal of heart failure

authors

Murphy NF,O'Loughlin C,Ledwidge M,McCaffrey D,McDonald K

doi

10.1016/j.ejheart.2007.10.001

subject

Has Abstract

pub_date

2007-12-01 00:00:00

pages

1196-204

issue

12

eissn

1388-9842

issn

1879-0844

pii

S1388-9842(07)00400-X

journal_volume

9

pub_type

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