Kaddoura Rasha, Chapra Ammar, Shah Jassim, Izham Mohamed, Singh Rajvir, Alsadi Haisam, Al-Amri Maha, Hamamyh Tahseen, Fallouh Manar, Elasad Farras, Abdelghani Mohamed, Alsaadi Alyafei Sumaya, Badr Amr, Patel Ashfaq
Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha 3050, Qatar.
Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha 3050, Qatar.
World J Cardiol. 2025 Jun 26;17(6):106717. doi: 10.4330/wjc.v17.i6.106717.
There is no available data about the trajectory of heart failure (HF) with improved ejection fraction (EF) and patient clinical outcomes in Qatar.
To explore the difference in characteristics and outcomes between patients with transient and sustained improvement in left ventricular ejection fraction (LVEF) and to determine the independent predictors for sustained improvement in LVEF.
This is a retrospective cohort study that was conducted at the advanced HF clinic of a tertiary care hospital in Qatar between January 2017 and December 2018. This study included adult patients with improved LVEF and had at least three echocardiographic studies. The patients were divided into two groups: HF with transient improvement in EF (HFtimpEF) and HF with sustained improvement in EF (HFsimpEF).
A total of 175 patients with HF and improved EF were included. Among them 136 (77.7%) patients showed sustained improvement in LVEF. The remaining patients with HFtimpEF were predominantly males [37 (94.9%) 101 (74.3%), = 0.005] with a higher incidence of ischemic cardiomyopathy [32 (82.1%) 68 (50.4%), = 0.002], dyslipidemia [24 (61.5%) 54 (39.7%), = 0.03], and hypertension [34 (87.2%) 93 (68.4%), = 0.03] than those with HFsimpEF. The latter experienced significantly lower rates of hospitalization [39 (28.7%) 20 (51.3%), = 0.01] and diagnosis of new cardiovascular conditions during the follow-up (, acute coronary syndrome, stroke, decompensated HF, and atrial fibrillation) [14 (10.3%) 10 (25.6%), = 0.03] without a difference in emergency department visits or in-hospital death. Sustained improvement in LVEF was positively associated with being female [adjusted odds ratio (aOR) = 6.8, 95% confidence interval (CI): 1.4-32.3, = 0.02], having non-ischemic etiology of HF (aOR = 3.1, 95%CI: 1.03-9.3, = 0.04), and using a mineralocorticoid receptor antagonist (aOR = 7.0, 95%CI: 1.50-31.8, = 0.01).
Patients with HFsimpEF experienced significantly lower rates of hospitalization and diagnosis of new cardiovascular conditions than patients with HFtimpEF. Sustained improvement in LVEF was positively associated with being a female, having non-ischemic etiology of HF, and using a mineralocorticoid receptor antagonist.
在卡塔尔，关于射血分数（EF）改善的心力衰竭（HF）轨迹及患者临床结局尚无可用数据。
探讨左心室射血分数（LVEF）短暂改善和持续改善的患者在特征及结局方面的差异，并确定LVEF持续改善的独立预测因素。
这是一项回顾性队列研究，于2017年1月至2018年12月在卡塔尔一家三级护理医院的晚期HF诊所进行。本研究纳入了LVEF改善且至少有三次超声心动图检查的成年患者。患者分为两组：EF短暂改善的HF（HFtimpEF）和EF持续改善的HF（HFsimpEF）。
共纳入175例HF且EF改善的患者。其中136例（77.7%）患者LVEF持续改善。其余HFtimpEF患者以男性为主[37例（94.9%）对101例（74.3%），P = 0.005]，缺血性心肌病发病率更高[32例（82.1%）对68例（50.4%），P = 0.002]，血脂异常[24例（61.5%）对54例（39.7%），P = 0.03]，高血压[34例（87.2%）对93例（68.4%），P = 0.03]。与HFsimpEF患者相比，HFtimpEF患者在随访期间住院率显著更低[39例（28.7%）对20例（51.3%），P = 0.01]，新发心血管疾病诊断率更低（急性冠状动脉综合征、中风、失代偿性HF和心房颤动）[14例（10.3%）对10例（25.6%），P = 0.03]，急诊就诊或院内死亡无差异。LVEF持续改善与女性（调整优势比[aOR]=6.8，95%置信区间[CI]：1.4 - 32.3，P = 0.02）、HF非缺血性病因（aOR = 3.1，95%CI：1.03 - 9.3，P = 0.04）以及使用盐皮质激素受体拮抗剂（aOR = 7.0，95%CI：1.50 - 31.8，P = 0.01）呈正相关。
与HFtimpEF患者相比，HFsimpEF患者住院率和新发心血管疾病诊断率显著更低。LVEF持续改善与女性、HF非缺血性病因以及使用盐皮质激素受体拮抗剂呈正相关。
