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Meta-Analysis
. 2022 Apr 2;10(2):21.
doi: 10.3390/medsci10020021.

Female Gender Is Associated with an Increased Left Ventricular Ejection Fraction Recovery in Patients with Heart Failure with Reduced Ejection Fraction

Jakrin Kewcharoen  1 , Angkawipa Trongtorsak  2 , Sittinun Thangjui  3 , Chanavuth Kanitsoraphan  4 , Narut Prasitlumkum  5
Affiliations
Meta-Analysis

Female Gender Is Associated with an Increased Left Ventricular Ejection Fraction Recovery in Patients with Heart Failure with Reduced Ejection Fraction

Jakrin Kewcharoen et al. Med Sci (Basel). .

Abstract

We performed a systematic review and meta-analysis to evaluate the association whether the female gender was associated with an increased chance of left ventricular ejection fraction (LVEF) in patients with heart failure with reduced ejection fraction (HFrEF). We searched the databases of MEDLINE and EMBASE from inception to 18 January 2022. Included studies were published studies evaluating or reporting characteristics of patients with HF with recovered LVEF. Data from each study were combined using a random-effects model, the generic inverse variance method of DerSimonian and Laird, to calculate odd ratios (OR) and 95% confidence intervals (CI). Eighteen studies were included in the analysis with a total of 12,270 patients (28.2% female). Female gender was associated with an increased chance of LVEF recovery (pooled OR = 1.50, 95% CI = 1.21−1.86, p-value < 0.001, I2 = 74.5%). In our subgroup analysis, female gender was associated with an increased chance of LVEF recovery when defined as LVEF > 50% (pooled OR = 1.78, 95% CI = 1.45−2.18, p-value < 0.001, I2 = 0.0%), and LVEF > 40−45% (pooled OR = 1.45, 95% CI = 1.09−1.91, p-value = 0.009, I2 = 79.2%), but not in LVEF > 35 (OR = 2.18, 95% CI = 0.94−5.05, p-value = 0.06). Our meta-analysis demonstrated that the female gender is associated with an increased chance of LVEF recovery. This association was not statistically significant in the subgroup that defined LVEF recovery as LVEF > 35%.

Keywords: LVEF recovery; female; heart failure; recovered LVEF; reduced LVEF.

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Conflict of interest statement

All author declares no conflict of interests.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Forest plot demonstrating odds ratio of association between female gender and incidence of left ventricular ejection recovery in patients with heart failure with reduced ejection fraction; (A) left ventricular ejection recovery cutoff value of >40–45%, (B) left ventricular ejection recovery cutoff value of >50%, (C) left ventricular ejection recovery cutoff value of >35%. Square with horizontal line represents OR and 95% CI for each individual study with square size reflecting the statistical weight of the study using the random-effects model. Diamond demonstrates pooled OR and 95% CI for each outcome. Heterogeneity (I2) with p-value, and pooled effect size (z) with p-value are reported below each of their respective forest plot. CI: Confidence interval; OR: Odds ratio.
Figure 3
Figure 3
Funnel plot of the included studies. Circles represent included studies. The vertical axis represents study size while the horizontal axis represents effect size. OR: Odds ratio; SE: Standard deviation.
See this image and copyright information in PMC

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