Heart failure with reduced ejection fraction (HFrEF) remains a leading cause of morbidity and mortality. While guideline-directed medical therapy (GDMT) has been shown to improve left ventricular ejection fraction (LVEF), real-world data on LVEF recovery and GDMT treatment have been limited—until now.
A new study from Truveta Research and collaborators sheds light on the trajectory of LVEF changes in HFrEF patients. Using Truveta Data, the study tracked over 320,000 patients with HFrEF over a year, examining how changes in LVEF were correlated with patient characteristics, GDMT use, and outcomes.
The findings highlight a major gap in care: two-thirds of patients received no follow-up echocardiograms within a year of their initial diagnosis. While guidelines don’t recommend routine LVEF reassessment without clinical changes or treatment adjustments, the high mortality in this group suggests suboptimal management.
Among those with repeat imaging:
- 57.5% achieved full LVEF recovery (HFrecEF)
- 18.6% improved to mid-range ejection fraction (HFmrEF)
- 23.9% remained in HFrEF, facing higher mortality rates
Patients who recovered were more likely to be female, white, and have fewer cardiovascular comorbidities. However, GDMT usage was notably low across all groups, despite its well-established benefits. This signals a critical gap in heart failure management—where even patients showing improvement may not be receiving optimal treatment.
Key takeaways
These findings highlight the need for better adherence to GDMT protocols and more frequent reassessments of heart function to ensure patients receive the best possible care. Increasing follow-up echocardiograms and optimizing medical therapy could significantly improve long-term outcomes for patients with heart failure.
While many patients with HFrEF show signs of recovery, low rates of GDMT usage suggest missed opportunities to improve survival and quality of life. Bridging this gap should be a priority for clinicians and healthcare systems alike.
Learn more in the full study available on MedRxiv.
