Association of Echocardiographic Indices with Left Ventricular Function Improvement in Heart Failure Patients

Introduction: Recent studies have shown that heart failure (HF) is not always a progressive disease. In a significant number of patients with heart failure with reduced ejection fraction (HFrEF), there is an improvement in left ventricular ejection fraction (LVEF), referred to as heart failure with recovered ejection fraction (HFrecEF). These patients have a better prognosis and lower mortality compared to other types of HF. The aim of this study is to identify echocardiographic indices associated with the improvement of left ventricular function in heart failure patients. Methods: This observational retrospective study was conducted on patients with heart failure (LVEF < 40%) who were admitted or visited as outpatients in a university hospital between 2020 and 2023. Patients were categorized into two groups based on LVEF at the second echocardiogram (at least three months after the first): HF Recovered EF and Persistent HF Reduced EF. LV end-diastolic diameter (LVEDd), left atrial diameter (LAD), and pulmonary artery pressure (PAP) were examined via echocardiogram. Data analysis was performed using SPSS 22, employing chi-square tests and logistic regression. A significance level of 0.05 was considered. Results: This study examined 291 patients (mean age 56.70 ± 14.70 years, 57.7% male). 26.3% of the patients were identified as having HFrecEF. The mean initial EF was 22.30 ± 8.59%, increasing to 27.98 ± 14.79% at follow-up. The average interval between echocardiograms was 11.17 ± 6.20 months. The mean LVEDd, LAD, and PAP were 59.73 ± 9.51 mm, 40.09 ± 5.21 mm, and 29.52 ± 11.53 mmHg, respectively. These values were significantly lower in the HFrecEF group compared to the persistent HFrEF group (P = 0.009, P = 0.005, and P < 0.001, respectively). Multivariate logistic regression showed that age (OR = 0.956, 95%CI = 0.919–0.994), time from symptom onset to echocardiogram (OR = 0.866, 95%CI = 0.809–0.928), initial EF (OR = 1.157, 95%CI = 1.080–1.240), and the interval between echocardiograms (OR = 1.109, 95%CI = 1.011–1.216) were significantly associated with improved left ventricular function (P < 0.05). Conclusion: In conclusion, certain background factors such as age and initial EF, the timing of diagnostic interventions, and follow-up, as well as echocardiographic findings, have significant associations with left ventricular function improvement. Further studies are recommended to validate these findings and explore additional echocardiographic indices.