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  • Title: Improvement but no cure of left ventricular systolic dysfunction in treated heart failure patients.
    Author: Murphy NF, O'Loughlin C, Ledwidge M, McCaffrey D, McDonald K.
    Journal: Eur J Heart Fail; 2007 Dec; 9(12):1196-204. PubMed ID: 18039520.
    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.
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