A new study of more than 28,000 individuals with newly diagnosed heart failure with reduced ejection fraction (HFrEF) has found that nearly one-third achieved improved heart function within a year. However, these patients still had a significant risk of worsening heart failure and death. The study was published in the Journal of the American College of Cardiology.

Researchers identified patients diagnosed with incident HFrEF between 2013 and 2022. Heart failure with improved ejection fraction (HFimpEF) was defined as a follow-up left ventricular ejection fraction above 40% with at least a 10% absolute increase within 12 months. Of 28,292 patients (average ejection fraction 31.1%), 8,656 (30.6%) met criteria for HFimpEF.

While guideline-directed medical therapy (GDMT) use was high at initial diagnosis, it slightly declined after patients transitioned to HFimpEF.

Those with HFimpEF had substantially lower event rates than patients with persistent HFrEF. The worsening heart failure occurred at 17.4 vs. 34.1 events per 100 person-years (HR: 0.58; 95% CI: 0.55–0.61), and death occurred at 5.7 vs. 11.0 per 100 person-years (HR: 0.52; 95% CI: 0.49–0.56). However, stopping GDMT was modestly associated with higher clinical risk.