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. 2022 May 13:9:846361.
doi: 10.3389/fmed.2022.846361. eCollection 2022.

Clinical Relevance of the LVEDD and LVESD Trajectories in HF Patients With LVEF < 35

Yu-Chen Chen  1   2 , Shi-Chue Hsing  3 , Yuan-Ping Chao  4   2 , Yung-Wen Cheng  4   2 , Chin-Sheng Lin  5 , Chin Lin  2   6   7 , Wen-Hui Fang  8
Affiliations

Clinical Relevance of the LVEDD and LVESD Trajectories in HF Patients With LVEF < 35

Yu-Chen Chen et al. Front Med (Lausanne). .

Abstract

Background: Certain variables reportedly are associated with a change in left ventricular ejection fraction (LVEF) in heart failure (HF) with reduced ejection fraction (HFrEF). However, literature describing the association between the recovery potential of LVEF and parameters of ventricular remodeling in echocardiography remains sparse.

Methods: We recruited 2,148 HF patients with LVEF < 35%. All patients underwent at least two echocardiographic images. The study aimed to compare LVEF alterations and their association with patient characteristics and echocardiographic findings.

Results: Patients with "recovery" of LVEF (follow-up LVEF ≥ 50%) were less likely to have prior myocardial infarction (MI), had a higher prevalence of atrial fibrillation (Af), were less likely to have diabetes and hypertension, and had a smaller left atrium (LA) diameter, left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD), both in crude and in adjusted models (adjustment for age and sex). LVEDD cutoff values of 59.5 mm in men and 52.5 mm in women and LVESD cutoff values of 48.5 mm in men and 46.5 mm in women showed a year-to-year increase in the rate of recovery (follow-up LVEF ≥ 50%)/improvement (follow-up LVEF ≥ 35%), p-value < 0.05 in Kaplan-Meier estimates of the cumulative hazard curves.

Conclusions: Our study shows that LVEDD and LVESD increments in echocardiography can be predictors of changes in LVEF in in HF patients with LVEF < 35%. They may be used to identify patients who require more aggressive therapeutic interventions.

Keywords: changes in ejection fraction; ejection fraction; heart failure with reduced ejection fraction (HFrEF); left ventricle end diastolic dimension (LVEDD); left ventricle end systolic dimension (LVESD).

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier estimates of the cumulative hazard for LVEDD cutoff values in LVEF alterations (A) LVEDD cutoff values of 59.5 mm in men and 52.5 mm in women showed a year-to-year increase in the rate of improvement (follow-up LVEF ≥ 35%). (B) LVEDD cutoff values of 59.5 mm in men and 52.5 mm in women showed a year-to-year increase in the rate of recovery (follow-up LVEF ≥ 50%).
Figure 2
Figure 2
Kaplan-Meier estimates of the cumulative hazard for LVESD cutoff values in LVEF alterations (A) LVESD cutoff values of 48.5 mm in men and 46.5 mm in women showed a year-to-year increase in the rate of improvement (follow-up LVEF ≥ 35%). (B) LVESD cutoff values of 48.5 mm in men and 46.5 mm in women showed a year-to-year increase in the rate of recovery (follow-up LVEF ≥ 50%).
See this image and copyright information in PMC

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