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Transient versus persistent improved ejection fraction in non-ischaemic dilated cardiomyopathy.
Manca, Paolo; Stolfo, Davide; Merlo, Marco; Gregorio, Caterina; Cannatà, Antonio; Ramani, Federica; Nuzzi, Vincenzo; Lund, Lars H; Savarese, Gianluigi; Sinagra, Gianfranco.
Afiliación
  • Manca P; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy.
  • Stolfo D; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy.
  • Merlo M; Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
  • Gregorio C; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy.
  • Cannatà A; Biostatistics Unit, Department of Medical Sciences, University of Trieste, Trieste, Italy.
  • Ramani F; MOX - Department of Mathematics, Politecnico di Milano, Milan, Italy.
  • Nuzzi V; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy.
  • Lund LH; Department of Cardiovascular Science, Faculty of Life Science and Medicine, King's College London, London, UK.
  • Savarese G; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy.
  • Sinagra G; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy.
Eur J Heart Fail ; 24(7): 1171-1179, 2022 07.
Article en En | MEDLINE | ID: mdl-35460146
AIMS: The recent definition of heart failure with improved ejection fraction outlined the importance of the longitudinal assessment of left ventricular ejection fraction (LVEF). However, long-term progression and outcomes of this subgroup are poorly explored. We sought to assess the LVEF trajectories and their correlations with outcome in non-ischaemic dilated cardiomyopathy (NICM) with improved ejection fraction (impEF). METHODS AND RESULTS: Consecutive NICM patients with baseline LVEF ≤40% enrolled in the Trieste Heart Muscle Disease Registry with ≥1 LVEF assessment after baseline were included. ImpEF was defined as a baseline LVEF ≤40%, and second evaluation showing both a ≥10% point increase from baseline LVEF and LVEF >40%. Transient impEF was defined by the documentation of recurrent LVEF ≤40% during follow-up. The primary endpoint was a composite of all-cause death, heart transplantation and left ventricular assist device (D/HT/LVAD). Among 800 patients, 460 (57%) had impEF (median time to improvement 13 months). Transient impEF was observed in 189 patients (41% of the overall impEF group) and was associated with higher risk of D/HT/LVAD compared with persistent impEF at multivariable analysis (hazard ratio 2.54; 95% confidence interval 1.60-4.04). The association of declining LVEF with the risk of D/HT/LVAD was non-linear, with a steep increase up to 8% points reduction, then remaining stable. CONCLUSIONS: In NICM, a 57% rate of impEF was observed. However, recurrent decline in LVEF was observed in ≈40% of impEF patients and it was associated with an increased risk of D/HT/LVAD.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cardiomiopatía Dilatada / Corazón Auxiliar / Insuficiencia Cardíaca Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: Eur J Heart Fail Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cardiomiopatía Dilatada / Corazón Auxiliar / Insuficiencia Cardíaca Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: Eur J Heart Fail Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido