TY - JOUR
T1 - Clinical Perspective of Myocardial Recovery and Improvement
T2 - Definitions, Prevalence, and Relevance
AU - Pensa, Anthony V.
AU - Zheng, Veronica
AU - Davis, Lucia
AU - Harap, Rebecca W.
AU - Wilcox, Jane E.
N1 - Publisher Copyright:
© 2024, Houston Methodist Debakey Heart and Vascular Center. All rights reserved.
PY - 2024
Y1 - 2024
N2 - Partial or complete imaging resolution of left ventricular (LV) systolic dysfunction in patients with heart failure with reduced ejection fraction (HFrEF) has gone by many names in the past few decades, including LV recovery, remission, reverse remodeling, and, most recently, improvement. This phenomenon has been described in a variety of clinical scenarios, including removal of an acute myocardial insult, unloading with durable LV assist devices, and treatment with various devices as well as pharmacotherapies, termed guideline-directed medical therapy (GDMT). Irrespective of definition, systolic improvement is associated with improved clinical outcomes compared to persistent systolic dysfunction. In the past few years, systolic improvement has been distinguished from HFrEF as a new clinical entity referred to as HF with improved EF (HFimpEF). Given the relative novelty of this condition, there is a paucity of data with regard to the clinical trajectory and management of this population. In this review, we describe the history of myocardial improvement terminology and explore notable findings that have led to the delineation of HFimpEF. Additionally, we highlight the importance of understanding LV trajectory and the potential opportunity for new GDMT management for clinicians when treating patients with HFimpEF.
AB - Partial or complete imaging resolution of left ventricular (LV) systolic dysfunction in patients with heart failure with reduced ejection fraction (HFrEF) has gone by many names in the past few decades, including LV recovery, remission, reverse remodeling, and, most recently, improvement. This phenomenon has been described in a variety of clinical scenarios, including removal of an acute myocardial insult, unloading with durable LV assist devices, and treatment with various devices as well as pharmacotherapies, termed guideline-directed medical therapy (GDMT). Irrespective of definition, systolic improvement is associated with improved clinical outcomes compared to persistent systolic dysfunction. In the past few years, systolic improvement has been distinguished from HFrEF as a new clinical entity referred to as HF with improved EF (HFimpEF). Given the relative novelty of this condition, there is a paucity of data with regard to the clinical trajectory and management of this population. In this review, we describe the history of myocardial improvement terminology and explore notable findings that have led to the delineation of HFimpEF. Additionally, we highlight the importance of understanding LV trajectory and the potential opportunity for new GDMT management for clinicians when treating patients with HFimpEF.
KW - heart failure trajectory
KW - heart failure with improved ejection fraction
KW - left ventricular reverse remodeling
KW - myocardial improvement
KW - myocardial recovery
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U2 - 10.14797/mdcvj.1441
DO - 10.14797/mdcvj.1441
M3 - Review article
C2 - 39184164
AN - SCOPUS:85202267290
SN - 1947-6094
VL - 20
SP - 6
EP - 15
JO - Methodist DeBakey cardiovascular journal
JF - Methodist DeBakey cardiovascular journal
IS - 4
ER -