Evidence map›Paper›PMID 39687932›Full record

ArticleAnnals of medicine2025

Characteristics, outcomes and the necessity of continued guideline-directed medical therapy in patients with heart failure with improved ejection fraction.

Qin-Fen Chen, Yindan Lu, Christos S Katsouras, Yangdi Peng, Junfang Sun, Mingming Li, Chenyang Liu, Hongxia Yao, Liyou Lian, Xiaofang Feng and 2 more

Abstract read
In one paragraph

Article in Annals of medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Qin-Fen ChenMedical Care Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.ORCID 0000-0001-6596-5004
Yindan LuDepartment of Cardiovascular Medicine, the Heart Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Christos S KatsourasSecond Department of Cardiology, University Hospital of Ioannina Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Yangdi PengDepartment of Respiratory Medicine, Yongjia County Traditional Chinese Medicine Hospital, Wenzhou, China.
Junfang SunDepartment of Cardiovascular Medicine, the Heart Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Mingming LiDepartment of Cardiovascular Medicine, the Heart Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Chenyang LiuDepartment of Cardiovascular Medicine, the Heart Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Hongxia YaoDepartment of Cardiovascular Medicine, the Heart Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Liyou LianDepartment of Cardiovascular Medicine, the Heart Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Xiaofang FengDepartment of Cardiovascular Medicine, the Heart Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Wei-Hong LinMedical Care Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Xiao-Dong ZhouDepartment of Cardiovascular Medicine, the Heart Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.ORCID 0000-0002-8534-0818

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMuch remains to be learned about patients with heart failure with improved ejection fraction (HFimpEF).

objectiveThis study sheds light on the characteristics and clinical outcomes of HFimpEF patients, including the consequences of halting guideline-directed medical therapy (GDMT).

methodsThis retrospective study was conducted on patients diagnosed with heart failure with reduced ejection fraction (HFrEF) who underwent a second echocardiogram at least 6 months apart between January 2009 and February 2023. The primary outcomes were major adverse cardiovascular events (MACEs), including all-cause mortality and heart failure hospitalization. The second outcome was recurrent HFrEF.

resultsOf 4,560 HFrEF patients were included, 3,289 (72.1%) achieved HFimpEF within a median follow-up period of 3.4 years (IQR: 1.8 - 5.9 years). Among these HFimpEF patients, recurrent HFrEF was observed in 941 (28.6%) patients during a median follow-up period of 2.3 years (IQR: 0.8-4.6 years). The proportion of patients who halted GDMT was 70.4%, 53.2%, 59.8% and 63.8% for MRA, beta-blockers, ACEI/ARB/ARNI and SGLT-2 inhibitors. Multivariable Cox analysis revealed ischemic heart disease, chronic kidney disease, coronary heart disease, lower left ventricular ejection fraction, larger left ventricular diastolic dimension and non-use GDMT are associated with recurrent HFrEF. Individuals without GDMT use exhibited lower chances of persistently recovering ejection fraction and high risks of MACEs compared to those who continue use.

conclusionsHFimpEF is a common condition across all clinical follow-ups. Prevalent discontinuation of GDMT medications may contribute significantly to recurrent HFrEF, placing patients at a higher risk for poor prognosis.

Indexed as

Heart FailureStroke VolumeAdrenergic beta-AntagonistsAgedAngiotensin-Converting Enzyme InhibitorsEchocardiographyFemaleHospitalizationHumansMaleMiddle AgedPractice Guidelines as TopicRecurrenceRetrospective StudiesAdrenergic beta-AntagonistsAngiotensin-Converting Enzyme Inhibitorsguideline-directed medical therapyheart failure with improved ejection fractionHeart failure with reduced ejection fractionleft ventricular ejection fractionprognosis

Identifiers

PMID39687932
PMCPMC11654040

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.